MEDICARE: PAP ORTHODONTICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1316459365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAP ORTHODONTICS PLLC

Provider Business Mailing Address
First Line	:	2120 KIMBALL HILL CT
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-7914
Country	:	US
Telephone Number	:	214-549-4340
Fax Number	:

Provider Business Practice Location Address
First Line	:	10909 WEBB CHAPEL RD STE 121
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-3739
Country	:	US
Telephone Number	:	214-549-4340
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANURAG PATEL
Credential	:	DMD, MS
Telephone Number	:	214-549-4340

Provider Enumeration Date	:	10/31/2017
Last Update Date	:	10/31/2017

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