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General NPI Number Information
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NPI Number | 1063326783
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Entity Type | Organization
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Legal Business Name | DENTISTS OF WALNUT GROVE, PC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 4271 FM 1387 STE 100
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-7634
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Country | US
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Telephone | 469-941-2081
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Fax | 469-537-7326
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Provider Business Mailing Address
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Address Line | PO BOX 660041
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City | DALLAS
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State | TX
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Zip | 75266-0041
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Country | US
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Telephone | 714-845-8890
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Fax | 303-952-0892
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Authorized Official
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Title or Position | OWNER
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Name | REMA ABDELJALIL
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Credential | DDS
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Telephone | 469-941-2081
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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 | NULL
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