Provider Demographics
NPI:1700421542
Name:P. LYNETTE PAGE, DDS, PLLC
Entity Type:Organization
Organization Name:P. LYNETTE PAGE, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-692-7499
Mailing Address - Street 1:6500 GREENVILLE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1030
Mailing Address - Country:US
Mailing Address - Phone:214-692-7499
Mailing Address - Fax:214-361-4145
Practice Address - Street 1:6500 GREENVILLE AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-1030
Practice Address - Country:US
Practice Address - Phone:214-692-7499
Practice Address - Fax:214-361-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty