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General NPI Number Information
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NPI Number | 1669928073
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Entity Type | Organization
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Legal Business Name | ROUND GROVE FAMILY DENTISTRY
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Dates
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Enumeration Date | 08/27/2016
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Last Update Date | 08/27/2016
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Provider Practice Location Address
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Address Line | 2325 S STEMMONS FWY STE 301
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City | LEWISVILLE
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State | TX
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Zip | 75067-8754
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Country | US
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Telephone | 469-556-8379
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 NORTHWEST HWY STE 103
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City | GARLAND
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State | TX
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Zip | 75041-4857
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | RANI JAMES
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Credential | DDS
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Telephone | 214-218-5917
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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 |
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License Number State |
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