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General NPI Number Information
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NPI Number | 1952954216
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Entity Type | Organization
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Legal Business Name | PROSPER DENTAL HEALTH, PLLC
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 2450 E PROSPER TRL STE 30
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City | PROSPER
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State | TX
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Zip | 75078-9286
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Country | US
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Telephone | 972-347-2233
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Fax | 972-347-2237
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Provider Business Mailing Address
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Address Line | 2450 E PROSPER TRL STE 30
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City | PROSPER
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State | TX
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Zip | 75078-9286
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Country | US
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Telephone | 972-347-2233
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Fax | 972-347-2237
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARISOL CHAVES-TRAUTMANN
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Credential | DDS, MS
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Telephone | 972-347-2233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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