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General NPI Number Information
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NPI Number | 1932408234
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Entity Type | Organization
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Legal Business Name | DENTON COUNTY ORAL AND MAXILLOFACIAL SURGERY
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Dates
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Enumeration Date | 03/25/2011
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 3307 UNICORN LAKE BLVD STE 191
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-382-4000
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Fax | 940-382-4001
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Provider Business Mailing Address
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Address Line | 3307 UNICORN LAKE BLVD STE 191
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-382-4000
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Fax | 940-382-4001
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMIT DHAMEJA
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Credential | D.D.S, M.D.
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Telephone | 940-382-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 25891
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License Number State | TX
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