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General NPI Number Information
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NPI Number | 1487711818
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Entity Type | Individual
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Provider Name | TAYO OGUNSOLA BDS,DMD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 6500 PRESTON RD SUITE #203
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City | FRISCO
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State | TX
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Zip | 75034-5856
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Country | US
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Telephone | 214-436-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 811 CAMDEN WAY
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City | PROSPER
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State | TX
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Zip | 75078-8460
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Country | US
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Telephone | 214-477-8661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18363
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License Number State | TX
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