Organization · Type 2 NPI
Sisombath Dental PC
Dental Clinic/Center · Prosper, TX
NPI number
1760134480
Active
Practice location
210 S Preston Rd Ste 60
Prosper, TX 75078-2780
Mailing address
5331 E Mockingbird Ln Apt 617
Dallas, TX 75206-0911
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 1760134480
Sisombath Dental PC's National Provider Identifier is 1760134480, issued on Jan 24, 2022. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Prosper, TX. The record was last updated on Jan 24, 2022.