NPI 1306232764

Richardspn Dental Professionals

Organisation Preferred Provider Organization Richardson, TX

Practice location

Address: 700 E Campbell Rd STE. #240, Richardson, TX 75081-2041
Phone: (972) 690-6653
Fax: (972) 680-8757

Authorised official

Name: Kerry Maxwell Goad
Title: General Dentist
Phone: (972) 690-6653

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 11808 (TX)

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Registry record

NPI: 1306232764
Entity type: Organization
NPI issued: 13 Apr 2015
Record last updated: 13 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.