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General NPI Number Information
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NPI Number | 1740413293
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Entity Type | Organization
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Legal Business Name | CAPSTONE DENTAL CARE PC
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 1517 BROOKLEAF DR.
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City | ARLINGTON
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State | TX
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Zip | 76018
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Country | US
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Telephone | 972-358-4877
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Fax | 469-574-5138
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Provider Business Mailing Address
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Address Line | 1631 COIT ROAD 114
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City | DALLAS
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State | TX
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Zip | 75248
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Country | US
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Telephone | 972-358-4877
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Fax | 469-574-5138
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | MRS. PAMELA PETERSON
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Credential |
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Telephone | 972-358-4877
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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 | TX
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