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General NPI Number Information
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NPI Number | 1942177753
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Entity Type | Organization
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Legal Business Name | FRESH START DENTAL PC
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1441 N COCKRELL HILL RD
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City | DALLAS
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State | TX
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Zip | 75211-1303
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Country | US
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Telephone | 214-330-7771
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Fax | 214-330-9242
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Provider Business Mailing Address
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Address Line | 1441 N COCKRELL HILL RD
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City | DALLAS
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State | TX
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Zip | 75211-1303
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Country | US
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Telephone | 214-330-7771
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Fax | 214-330-9242
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Authorized Official
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Title or Position | DMD
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Name | ADEYINKA O ANYAEGBU
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Credential |
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Telephone | 214-330-7771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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