| NPI | 1972354447 | 
|---|---|
| Doing Business As | PROGRESSIVE PERIODONTICS | 
| Entity Type | Organization | 
| Authorized Contact | JENNY GARCIA ROCHA Sr Credentialing Team Lead 972-869-3789 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0300X Dentist, Periodontics | 
| Enumeration Date | 2024-04-01 | 
| Last Update Date | 2024-04-01 |