| NPI | 1053688895 | 
|---|---|
| Doing Business As | HERITAGE DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | MATT HENDRICKSON Owner 972-542-4402  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 20486)  | 
| Enumeration Date | 2011-11-22 | 
| Last Update Date | 2011-11-22 |