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General NPI Number Information
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NPI Number | 1629253893
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Entity Type | Organization
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Legal Business Name | KB DENTAL II P.C.
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 1071 W FM 3040 STE800
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City | LEWISVILLE
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State | TX
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Zip | 75067-7904
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Country | US
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Telephone | 972-459-7500
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Fax | 972-459-7555
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Provider Business Mailing Address
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Address Line | 1071 W FM 3040 STE800
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City | LEWISVILLE
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State | TX
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Zip | 75067-7904
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Country | US
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Telephone | 972-459-7500
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Fax | 972-459-7555
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BINDU M KOLLI
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Credential | D.M.D.
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Telephone | 972-459-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21085
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License Number State | TX
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