Organization · Type 2 NPI
Grand Prairie Marvel Dental PLLC
Dental Clinic/Center · Grand Prairie, TX
NPI number
1629586797
Active
Practice location
5020 S Hwy 360, Suite 200
Grand Prairie, TX 75052
Mailing address
2401 Cabrillo Ln
Mansfield, TX 76063-4117
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1629586797
Grand Prairie Marvel Dental PLLC's National Provider Identifier is 1629586797, issued on Jan 11, 2018. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Grand Prairie, TX. The record was last updated on Jan 11, 2018.