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	:	1538350442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL EXPERTS PA

Provider Business Mailing Address
First Line	:	2315 GUS THOMASSON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3004
Country	:	US
Telephone Number	:	214-660-3330
Fax Number	:	214-660-3340

Provider Business Practice Location Address
First Line	:	2315 GUS THOMASSON RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-3004
Country	:	US
Telephone Number	:	214-660-3330
Fax Number	:	214-660-3340

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

Provider Enumeration Date	:	08/06/2007
Last Update Date	:	07/21/2022

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Directions to “DENTAL EXPERTS PA ” Practice Location

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