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General NPI Number Information
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NPI Number | 1356595201
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Entity Type | Organization
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Legal Business Name | PARK CITIES DENTAL GROUP LLP
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 3110 WEBB AVE STE 300
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City | DALLAS
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State | TX
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Zip | 75205-3445
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Country | US
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Telephone | 214-528-7870
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Fax | 214-526-1761
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Provider Business Mailing Address
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Address Line | 3110 WEBB AVE STE 300
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City | DALLAS
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State | TX
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Zip | 75205-3445
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Country | US
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Telephone | 214-528-7870
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Fax | 214-526-1761
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Authorized Official
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Title or Position | FRONT OFFICE
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Name | MRS. CINDY L SMITH
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Credential |
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Telephone | 214-528-7870
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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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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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