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General NPI Number Information
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NPI Number | 1174022370
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER A EMDIN DDS PLLC
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Dates
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Enumeration Date | 02/03/2018
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Last Update Date | 02/03/2018
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Provider Practice Location Address
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Address Line | 2200 AIRPORT FWY STE 480
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City | BEDFORD
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State | TX
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Zip | 76022-6048
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Country | US
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Telephone | 817-785-3290
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Fax |
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Provider Business Mailing Address
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Address Line | 5310 WOOD CREEK LN
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City | GARLAND
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State | TX
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Zip | 75044-4916
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Country | US
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Telephone | 682-999-7751
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHRISTOPHER A EMDIN
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Credential | DDS
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Telephone | 682-999-7751
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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 | 31102
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License Number State | TX
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