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NPI 1255097176

NPI 1255097176 : ARLINGTON MODERN DENTISTRY PC : ARLINGTON, TX

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General NPI Number Information
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    NPI Number           |    1255097176
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    Entity Type          |    Organization 
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    Legal Business Name  |    ARLINGTON MODERN DENTISTRY PC 
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Dates
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    Enumeration Date     |    11/15/2021
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    Last Update Date     |    11/15/2021
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Provider Practice Location Address
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    Address Line         |    4407 LITTLE RD STE 600 
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    City                 |    ARLINGTON
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    State                |    TX
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    Zip                  |    76016-5626
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    Country              |    US
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    Telephone            |    682-273-0025
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    Fax                  |    682-276-2735
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Provider Business Mailing Address
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    Address Line         |    PO BOX 920050 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75392-0050
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    Country              |    US
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    Telephone            |    714-845-8500
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER DENTIST
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    Name                 |    DR. SABRINA  CHAVEZ-KELLER 
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    Credential           |    DDS
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    Telephone            |    682-273-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    
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    License Number State |    
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