MEDICARE: DENTAL EXPERTS, PA

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
1	1223G0001X	General Practice Dentistry		TX

General Provider Information

NPI Number	:	1386834182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL EXPERTS, PA

Provider Business Mailing Address
First Line	:	1111 W AIRPORT FWY
Second Line	:	UNIT 121
City	:	IRVING
State	:	TX
Zip	:	75062-6203
Country	:	US
Telephone Number	:	214-596-0003
Fax Number	:	214-596-0751

Provider Business Practice Location Address
First Line	:	1111 W AIRPORT FWY STE 121
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-6204
Country	:	US
Telephone Number	:	214-596-0003
Fax Number	:	214-596-0751

Authorized Official
Title or Position	:	DIRECTOR DOCTOR CREDENTIALING
Name	:	PHIL KURAL
Credential	:
Telephone Number	:	630-750-1405

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	07/21/2022

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Directions to “DENTAL EXPERTS, PA ” Practice Location

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