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General NPI Number Information
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NPI Number | 1417593302
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Entity Type | Organization
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Legal Business Name | KATHRINA CARRASCO DENTAL SERVICES, PLLC
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 6513 PRESTON RD STE 500
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City | PLANO
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State | TX
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Zip | 75024-2711
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Country | US
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Telephone | 972-378-6762
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Fax | 972-378-6771
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Provider Business Mailing Address
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Address Line | 6513 PRESTON RD STE 500
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City | PLANO
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State | TX
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Zip | 75024-2711
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Country | US
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Telephone | 972-378-6762
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Fax | 972-378-6771
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. KATHRINA CARRASCO
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Credential | DDS
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Telephone | 805-551-9058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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