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General NPI Number Information
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NPI Number | 1285865493
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Entity Type | Organization
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Legal Business Name | DENTAL EXPRESSIONS, P.C.
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Dates
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Enumeration Date | 08/05/2009
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 3330 N GALLOWAY AVE SUITE 306
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City | MESQUITE
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State | TX
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Zip | 75150-4756
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Country | US
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Telephone | 214-228-5094
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 N GALLOWAY AVE SUITE 306
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City | MESQUITE
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State | TX
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Zip | 75150-4728
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Country | US
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Telephone | 214-228-5094
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANA LY
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Credential | D.D.S.
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Telephone | 469-951-9717
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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 | 21049
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License Number State | TX
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