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General NPI Number Information
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NPI Number | 1568344828
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Entity Type | Organization
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Legal Business Name | SUN DENTAL GROUP PLLC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 1201 S W S YOUNG DR STE D
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City | KILLEEN
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State | TX
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Zip | 76543-4887
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Country | US
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Telephone | 254-690-3380
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S W S YOUNG DR STE D
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City | KILLEEN
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State | TX
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Zip | 76543-4887
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Country | US
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Telephone | 254-690-3380
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Fax | 254-690-3668
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | SAVITHA YANNAM
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Credential | DDS
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Telephone | 603-943-4594
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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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