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General NPI Number Information
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NPI Number | 1003329293
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Entity Type | Organization
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Legal Business Name | PRESTON COMMONS DENTAL CARE PLLC
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 8117 PRESTON RD
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City | DALLAS
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State | TX
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Zip | 75225-6332
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Country | US
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Telephone | 214-361-6302
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Fax | 214-265-7022
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Provider Business Mailing Address
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Address Line | 8117 PRESTON RD 150 W
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City | DALLAS
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State | TX
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Zip | 75225-6332
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Country | US
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Telephone | 214-361-6302
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Fax | 214-265-7022
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHARLES STETLER
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Credential | DDS
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Telephone | 214-361-6302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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