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NPI 1043783657

NPI 1043783657 : SANGER DENTAL-SANGER PLLC : SANGER, TX

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General NPI Number Information
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    NPI Number           |    1043783657
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    Entity Type          |    Organization 
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    Legal Business Name  |    SANGER DENTAL-SANGER PLLC 
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Dates
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    Enumeration Date     |    01/07/2019
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    Last Update Date     |    01/07/2019
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Provider Practice Location Address
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    Address Line         |    617 N 10TH ST STE 204 
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    City                 |    SANGER
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    State                |    TX
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    Zip                  |    76266-4241
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    Country              |    US
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    Telephone            |    940-302-5005
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    Fax                  |    940-302-5211
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Provider Business Mailing Address
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    Address Line         |    1261 W GREEN OAKS BLVD STE 101 
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    City                 |    ARLINGTON
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    State                |    TX
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    Zip                  |    76013-8349
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CREDENTIALING
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    Name                 |     TEE  SEMERA 
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    Credential           |    
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    Telephone            |    469-556-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    
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    License Number State |    
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