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NPI Code Detail

MEDICARE: TOWN CENTER DENTAL

MEDICARE: TOWN CENTER DENTAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry21427TX

General Provider Information

NPI Number : 1124209556
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOWN CENTER DENTAL
Provider Business Mailing Address
First Line : 4430 LAVON DR STE 370
Second Line :
City : GARLAND
State : TX
Zip : 75040-2974
Country : US
Telephone Number : 972-530-5200
Fax Number :
Provider Business Practice Location Address
First Line : 4430 LAVON DR STE 370
Second Line :
City : GARLAND
State : TX
Zip : 75040-2974
Country : US
Telephone Number : 972-530-5200
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. TERESA H KNOTT
Credential : DDS
Telephone Number : 972-530-5200
Provider Enumeration Date : 11/14/2007
Last Update Date : 11/14/2007

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Directions to “TOWN CENTER DENTAL ” Practice Location

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