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General NPI Number Information
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NPI Number | 1013390525
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Entity Type | Organization
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Legal Business Name | DENTAL IMPRESSIONS PC
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Dates
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Enumeration Date | 07/01/2015
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 3401 WOLFE CIR
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City | PLANO
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State | TX
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Zip | 75025-2227
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Country | US
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Telephone | 214-862-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 151 RIDGE POINT PKWY SUITE 400
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City | KELLER
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State | TX
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Zip | 76248
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Country | US
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Telephone | 214-862-3100
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | SWEETA NAGPAL
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Credential | DMD
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Telephone | 214-862-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22451
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License Number State | TX
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