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General NPI Number Information
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NPI Number | 1538889050
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Entity Type | Organization
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Legal Business Name | THE DENTAL GROVE
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 09/02/2022
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Provider Practice Location Address
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Address Line | 1580 W FRONTIER PKWY
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City | PROSPER
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State | TX
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Zip | 75078
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Country | US
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Telephone | 972-370-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 2016 USA DR
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City | PLANO
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State | TX
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Zip | 75025-3107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NEHA KHANOLKAR
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Credential | DDS
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Telephone | 469-877-6384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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