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General NPI Number Information
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NPI Number | 1720746647
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Entity Type | Organization
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Legal Business Name | SOUTH PLANO FAMILY DENTISTRY, PLLC
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1332 S PLANO RD STE 530
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City | RICHARDSON
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State | TX
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Zip | 75081-5954
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Country | US
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Telephone | 940-220-7833
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Fax |
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Provider Business Mailing Address
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Address Line | 1332 S PLANO RD STE 534
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City | RICHARDSON
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State | TX
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Zip | 75081-5956
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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/DENTIST
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Name | EVERETT CHAD EVANS
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Credential | DDS
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Telephone | 940-220-7833
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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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