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General NPI Number Information
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NPI Number | 1295124667
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Entity Type | Organization
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Legal Business Name | NORTH DALLAS DENTAL HEALTH PLLC
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 5465 BLAIR ROAD, SUITE 200
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City | DALLAS
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State | TX
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Zip | 75231
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Country | US
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Telephone | 214-691-2404
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Fax | 214-691-2228
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Provider Business Mailing Address
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Address Line | 5465 BLAIR RD STE 200
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City | DALLAS
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State | TX
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Zip | 75231-4163
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Country | US
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Telephone | 214-691-2404
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Fax | 214-691-2228
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY D POPE
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Credential | D.D.S.
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Telephone | 214-691-2404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 9710
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 24589
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License Number State | TX
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