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General NPI Number Information
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NPI Number | 1043336860
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Entity Type | Organization
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Legal Business Name | NORTH DALLAS ENT GROUP
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 12720 HILLCREST RD STE 900
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City | DALLAS
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State | TX
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Zip | 75230-2047
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Country | US
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Telephone | 972-566-8300
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Fax | 972-566-8004
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Provider Business Mailing Address
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Address Line | 9330 LBJ FWY STE 800
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City | DALLAS
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State | TX
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Zip | 75243-4310
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Country | US
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Telephone | 972-566-8300
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Fax | 972-566-8004
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MICHELLE DENISE BANNO
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Credential |
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Telephone | 972-566-4071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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