TX SOUTHERN DENTAL PPO PC

BEDFORD, TX
NPI1902676380
Doing Business AsCLASSIC DENTAL WELLNESS
Entity TypeOrganization
Authorized ContactERIKA MELISSA MENJIVAR
Sr. Credentialing Specialist
469-596-6137
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2024-01-05
Last Update Date2025-08-13
Business Address
TX SOUTHERN DENTAL PPO PC
2205 HARWOOD RD
BEDFORD, TX 76021-3607
Phone number: 817-354-0606
Mailing Address
TX SOUTHERN DENTAL PPO PC
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number: