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2014 N Highway 78 Ste 150 Wylie TX 75098-6091 | |
| (972) 442-6879 | |
| (972) 429-7923 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2014 N Highway 78 Ste 150, Wylie, Texas |
| Authorized Official Name and Position | Sharon Garza (CREDENTIALING MANAGER) |
| Authorized Official Contact | 4697067057 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2014 N Highway 78 Ste 150 Wylie TX 75098-6091 Ph: (972) 442-6879 | 2014 N Highway 78 Ste 150 Wylie TX 75098-6091 Ph: (972) 442-6879 |
| NPI Number | 1316595168 |
|---|---|
| Provider Enumeration Date | 08/26/2019 |
| Last Update Date | 08/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316595168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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