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General NPI Number Information
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NPI Number | 1619137221
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Entity Type | Organization
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Legal Business Name | ZENA DENTAL PLLC
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 445 E FM 1382 SUITE 6
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City | CEDAR HILL
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State | TX
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Zip | 75104-6047
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Country | US
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Telephone | 469-272-0003
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Fax | 469-272-0004
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Provider Business Mailing Address
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Address Line | 445 E FM 1382 SUITE 6
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City | CEDAR HILL
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State | TX
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Zip | 75104-6047
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Country | US
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Telephone | 469-272-0003
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Fax | 469-272-0004
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ENEHIZENA N EHONDOR
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Credential |
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Telephone | 469-272-0003
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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 | 22405
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License Number State | TX
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