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NPI 1508411844

NPI 1508411844 : STEVEN CHRISTOPHER RENAS DMD : CARROLLTON, TX

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General NPI Number Information
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    NPI Number           |    1508411844
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN CHRISTOPHER RENAS DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/05/2019
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    Last Update Date     |    08/05/2019
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Provider Practice Location Address
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    Address Line         |    1930 E ROSEMEADE PKWY STE 103 
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    City                 |    CARROLLTON
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    State                |    TX
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    Zip                  |    75007-2467
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    Country              |    US
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    Telephone            |    972-492-0411
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2502 THOMAS AVE APT 121 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75201-2077
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    Country              |    US
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    Telephone            |    630-624-1265
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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       |    35322
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    License Number State |    TX
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