NPI 1457164758
DC Southern Dental Ppo PC
Practice location
- Address
- 1625 K St NW # Ll, Washington, DC 20006-1604
- Phone
- (202) 463-2090
- Mailing address
- 5830 Granite Pkwy STE 780m, Plano, TX 75024-6775
Authorised official
- Name
- Erika Menjivar
- Title
- Sr. Credentialing Specialist
- Phone
- (469) 596-6137
Registered specialties
Denturist
Primary
Registry record
- NPI
- 1457164758
- Entity type
- Organization
- NPI issued
- 30 Jan 2025
- Record last updated
- 30 Jan 2025
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.