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General NPI Number Information
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NPI Number | 1245543404
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Entity Type | Individual
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Provider Name | TODD ALAN DENT D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2010
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 3084 NORTH GOLIAD STREET 114
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City | ROCKWALL
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State | TX
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Zip | 75087
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Country | US
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Telephone | 972-977-3911
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Fax |
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Provider Business Mailing Address
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Address Line | 2723 JORDAN POINTE BLVD
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City | NEW HILL
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State | NC
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Zip | 27562-9306
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Country | US
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Telephone | 919-545-4394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 11490
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License Number State | TX
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