MEDICARE: DONNA R ROLLINS DDS PC

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	1223G0001X	General Practice Dentistry	18151	TX

General Provider Information

NPI Number	:	1578908984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONNA R ROLLINS DDS PC

Provider Business Mailing Address
First Line	:	1226 NORTHWEST HWY
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-5834
Country	:	US
Telephone Number	:	972-686-4700
Fax Number	:	972-686-4965

Provider Business Practice Location Address
First Line	:	1226 NORTHWEST HWY
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-5834
Country	:	US
Telephone Number	:	972-686-4700
Fax Number	:	972-686-4965

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	DR. DONNA ROBINSON ROLLINS
Credential	:	DDS
Telephone Number	:	972-686-4700

Provider Enumeration Date	:	04/30/2013
Last Update Date	:	04/30/2013

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