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General NPI Number Information
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NPI Number | 1215397815
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Entity Type | Organization
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Legal Business Name | ENDODONTIC ASSOCIATES OF FRISCO, PLLC
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 12655 N CENTRAL EXPY 1014
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City | DALLAS
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State | TX
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Zip | 75243-1700
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Country | US
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Telephone | 214-342-0425
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Fax |
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Provider Business Mailing Address
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Address Line | 5350 INDEPENDENCE PKWY, STE 150
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City | FRISCO
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State | TX
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Zip | 75035
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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 | OWNER
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Name | YOGESH T PATEL
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Credential | DDS
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Telephone | 214-342-0425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 20123
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License Number State | TX
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