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General NPI Number Information
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NPI Number | 1235519406
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Entity Type | Organization
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Legal Business Name | KNOX VILLAGE DENTISTRY AND ORTHODONTICS PLLC
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 2325 N FITZHUGH AVE STE 200
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City | DALLAS
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State | TX
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Zip | 75204-3058
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Country | US
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Telephone | 214-265-7771
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Fax | 214-559-7078
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Provider Business Mailing Address
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Address Line | 2325 N FITZHUGH AVE STE 200
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City | DALLAS
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State | TX
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Zip | 75204-3058
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Country | US
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Telephone | 214-265-7771
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Fax | 214-559-7078
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MELISSA SIGMAN
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Credential |
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Telephone | 972-292-3092
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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 | TX
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