Provider Demographics
NPI:1114664075
Name:DALLAS DENTAL IMPLANT AND ORTHODONTIC CENTER PLLC
Entity Type:Organization
Organization Name:DALLAS DENTAL IMPLANT AND ORTHODONTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:CHEI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-326-9077
Mailing Address - Street 1:1220 AIRPORT FWY STE F
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6776
Mailing Address - Country:US
Mailing Address - Phone:817-508-0084
Mailing Address - Fax:682-503-4577
Practice Address - Street 1:1220 AIRPORT FWY STE F
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6776
Practice Address - Country:US
Practice Address - Phone:817-508-0084
Practice Address - Fax:682-503-4577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental