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General NPI Number Information
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NPI Number | 1568625317
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD DENTAL
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 6803 PRESTON RD UNIT 122
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City | FRISCO
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State | TX
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Zip | 75034-5823
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Country | US
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Telephone | 972-712-9595
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Fax | 972-712-9594
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Provider Business Mailing Address
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Address Line | 6803 PRESTON RD UNIT 122
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City | FRISCO
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State | TX
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Zip | 75034-5823
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Country | US
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Telephone | 972-712-9595
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Fax | 972-712-9594
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MOHAMMADREZA DEHGHANY
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Credential | DMD
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Telephone | 972-712-9595
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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 | 22430
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License Number State | TX
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