TX SOUTHERN DENTAL PPO PC

LEAGUE CITY, TX
NPI1407682511
Doing Business AsBAY AREA DENTAL CENTER
Entity TypeOrganization
Authorized ContactERIKA MELISSA MENJIVAR
Sr. Credentialing Specialist
469-596-6137
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2024-09-13
Last Update Date2024-09-25
Business Address
TX SOUTHERN DENTAL PPO PC
6011 W MAIN ST STE A101
LEAGUE CITY, TX 77573-7541
Phone number: 281-338-6559
Mailing Address
TX SOUTHERN DENTAL PPO PC
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number: