Healthcare Provider Details

I. General information

NPI: 1609698935
Provider Name (Legal Business Name): AFFORDABLE DENTIST NEAR ME OF DENTON PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3969 TEASLEY LN STE 1500
DENTON TX
76210-8468
US

IV. Provider business mailing address

3969 TEASLEY LN STE 1500
DENTON TX
76210-8468
US

V. Phone/Fax

Practice location:
  • Phone: 817-496-2343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: CINTIA VILLEDA
Title or Position: MANAGER
Credential:
Phone: 903-441-1558