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General NPI Number Information
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NPI Number | 1568945269
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Entity Type | Organization
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Legal Business Name | BL DENTAL & ORTHODONTICS PLLC
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 2200 LOS RIOS BLVD STE 100
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City | PLANO
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State | TX
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Zip | 75074-3478
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Country | US
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Telephone | 469-666-3730
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Fax | 469-666-3732
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Provider Business Mailing Address
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Address Line | 2200 LOS RIOS BLVD STE 100
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City | PLANO
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State | TX
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Zip | 75074-3478
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Country | US
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Telephone | 469-666-3730
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Fax | 469-666-3732
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Authorized Official
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Title or Position | DENTIST
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Name | MOHAMMAD CHOWDHURY
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Credential | DDS
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Telephone | 469-666-3730
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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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Taxonomy #2
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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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