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General NPI Number Information
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NPI Number | 1548685100
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Entity Type | Organization
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Legal Business Name | THE DENTAL TEAM, PLLC
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 10611 GARLAND RD SUITE 205
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City | DALLAS
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State | TX
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Zip | 75218-2666
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Country | US
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Telephone | 214-321-3005
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Fax | 214-321-7942
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Provider Business Mailing Address
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Address Line | 10611 GARLAND RD SUITE 205
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City | DALLAS
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State | TX
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Zip | 75218-2666
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Country | US
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Telephone | 214-321-3005
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Fax | 214-321-7942
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Authorized Official
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Title or Position | OWNER
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Name | DR. DENNIS EARL YOUNGBLOOD
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Credential | D.D.S.
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Telephone | 214-718-2099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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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 | 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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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #5
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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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