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General NPI Number Information
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NPI Number | 1265854988
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Entity Type | Organization
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Legal Business Name | DFW ORAL AND MAXILLOFACIAL SURGERY MESQUITE, LLC
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 01/15/2014
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Provider Practice Location Address
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Address Line | 2540 N GALLOWAY AVE STE. 303, BLDG 3
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City | MESQUITE
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State | TX
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Zip | 75150-6306
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Country | US
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Telephone | 972-270-6617
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Fax | 972-270-8381
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Provider Business Mailing Address
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Address Line | 2727 N. O'CONNOR RD
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City | IRVING
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State | TX
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Zip | 75062
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Country | US
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Telephone | 972-594-7414
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Fax | 972-594-1834
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PEDRO F FRANCO
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Credential | DDS
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Telephone | 972-594-7414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 20816
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License Number State | TX
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