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General NPI Number Information
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NPI Number | 1114372588
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Entity Type | Organization
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Legal Business Name | ALLEN FAIZ DDS PA
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 1311 WEST CAMPBELL RD
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City | RICHARDSON
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State | TX
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Zip | 75080
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Country | US
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Telephone | 972-231-3188
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Fax | 972-231-3148
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Provider Business Mailing Address
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Address Line | 1311 W CAMPBELL RD
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City | RICHARDSON
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State | TX
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Zip | 75080-2815
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Country | US
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Telephone | 972-231-3188
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Fax | 972-231-3148
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Authorized Official
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Title or Position | RECEP/ CREDENTIALING
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Name | VALITA WATSON
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Credential |
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Telephone | 972-231-3188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 18506
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License Number State | TX
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