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NPI Code Detail

MEDICARE: DENTAL HEALTH ASSOCIATES OF TEXAS, PC

MEDICARE: DENTAL HEALTH ASSOCIATES OF TEXAS, PC
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 Dentistry20135TX
21223G0001XGeneral Practice Dentistry20748TX
31223G0001XGeneral Practice Dentistry16034TX
41223G0001XGeneral Practice Dentistry15772TX

General Provider Information

NPI Number : 1609089937
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL HEALTH ASSOCIATES OF TEXAS, PC
Provider Business Mailing Address
First Line : 1760 W VIRGINIA ST
Second Line : STE 100
City : MCKINNEY
State : TX
Zip : 75069-7864
Country : US
Telephone Number : 972-547-6453
Fax Number : 972-542-0121
Provider Business Practice Location Address
First Line : 1760 W VIRGINIA ST
Second Line : STE 100
City : MCKINNEY
State : TX
Zip : 75069-7864
Country : US
Telephone Number : 972-547-6453
Fax Number : 972-542-0121
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : HANNAH FISH
Credential :
Telephone Number : 217-540-5699
Provider Enumeration Date : 05/07/2007
Last Update Date : 07/09/2024

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