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NPI Code Detail

MEDICARE: BL DENTAL & ORTHODONTICS PLLC

MEDICARE: BL DENTAL & ORTHODONTICS 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
1261QD0000XDental Clinic/Center
21223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1568945269
Entity Type Code : Organization
Provider Name (Legal Business Name) : BL DENTAL & ORTHODONTICS PLLC
Provider Business Mailing Address
First Line : 2200 LOS RIOS BLVD STE 100
Second Line :
City : PLANO
State : TX
Zip : 75074-3478
Country : US
Telephone Number : 469-666-3730
Fax Number : 469-666-3732
Provider Business Practice Location Address
First Line : 2200 LOS RIOS BLVD STE 100
Second Line :
City : PLANO
State : TX
Zip : 75074-3478
Country : US
Telephone Number : 469-666-3730
Fax Number : 469-666-3732
Authorized Official
Title or Position : DENTIST
Name : MOHAMMAD CHOWDHURY
Credential : DDS
Telephone Number : 469-666-3730
Provider Enumeration Date : 09/10/2018
Last Update Date : 02/05/2019

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Directions to “BL DENTAL & ORTHODONTICS PLLC ” Practice Location

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