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General NPI Number Information
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NPI Number | 1699224956
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Entity Type | Organization
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Legal Business Name | MESQUITE CROSSING DENTAL, PA
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 09/28/2016
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Provider Practice Location Address
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Address Line | 2110 N GALLOWAY AVE SUITE 104-105
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City | MESQUITE
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State | TX
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Zip | 75150-5713
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Country | US
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Telephone | 214-420-7000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 541448
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City | DALLAS
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State | TX
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Zip | 75354-1448
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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
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Name | DR. ROBERT E TAFEL
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Credential | D.D.S.
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Telephone | 214-420-7000
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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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