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General NPI Number Information
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NPI Number | 1902040751
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Entity Type | Organization
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Legal Business Name | RENEW DENTAL P.C
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 11955 DALLAS PARKWAY SUITE 100
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City | FRISCO
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State | TX
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Zip | 75034
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Country | US
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Telephone | 214-705-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 8117 DAVIDSON DR
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City | PLANO
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State | TX
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Zip | 75025-2577
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Country | US
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Telephone | 214-335-5116
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MEERA DAHIYA
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Credential | D.D.S
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Telephone | 214-335-5116
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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 | 18716
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License Number State | TX
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