| NPI | 1437887254 | 
|---|---|
| Doing Business As | PRO DENTAL DALLAS | 
| Entity Type | Organization | 
| Authorized Contact | JASON DEREK ROE Dentist/Owner 972-931-1777  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics | 
| Enumeration Date | 2022-08-10 | 
| Last Update Date | 2022-08-10 |