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General NPI Number Information
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NPI Number | 1164381638
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Entity Type | Organization
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Legal Business Name | ROCK DENTAL TEXAS PLLC
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 1921 N PRESTON RD STE 80
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City | PROSPER
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State | TX
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Zip | 75078-2788
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Country | US
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Telephone | 972-934-6222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3450
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City | LITTLE ROCK
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State | AR
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Zip | 72203-3450
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Country | US
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Telephone | 501-781-2777
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Fax | 501-781-2778
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | SHAY PHILMO PHILMON
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Credential |
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Telephone | 501-462-2062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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