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NPI Code Detail

MEDICARE: PARKWAY VISTA DENTAL PLLC

MEDICARE: PARKWAY VISTA DENTAL PLLC
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 Dentistry20179432TX

General Provider Information

NPI Number : 1427057678
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARKWAY VISTA DENTAL PLLC
Provider Business Mailing Address
First Line : 5072 W PLANO PKWY
Second Line : SUITE 250
City : PLANO
State : TX
Zip : 75093-4476
Country : US
Telephone Number : 972-818-1300
Fax Number : 972-818-1301
Provider Business Practice Location Address
First Line : 5072 W PLANO PKWY
Second Line : SUITE 250
City : PLANO
State : TX
Zip : 75093-4476
Country : US
Telephone Number : 972-818-1300
Fax Number : 972-818-1301
Authorized Official
Title or Position : OWNER
Name : DR. KATHRYN L. MINTON
Credential : DDS
Telephone Number : 972-818-1300
Provider Enumeration Date : 07/19/2005
Last Update Date : 08/22/2020

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Directions to “PARKWAY VISTA DENTAL PLLC ” Practice Location

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