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General NPI Number Information
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NPI Number | 1922529874
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Entity Type | Organization
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Legal Business Name | DENTIUM PEDIATRIC DENTAL P.C.
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2626 STONEBROOK PKWY STE 200
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City | FRISCO
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State | TX
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Zip | 75034-1393
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Country | US
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Telephone | 972-987-0787
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Fax |
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Provider Business Mailing Address
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Address Line | 2626 STONEBROOK PKWY STE 200
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City | FRISCO
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State | TX
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Zip | 75034-1393
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Country | US
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Telephone | 972-987-0787
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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. SOLMAZ SHIR
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Credential | DDS
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Telephone | 972-987-0787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 28104
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License Number State | TX
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