Provider Demographics
NPI:1902040751
Name:RENEW DENTAL P.C
Entity Type:Organization
Organization Name:RENEW DENTAL P.C
Other - Org Name:RENEW FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-335-5116
Mailing Address - Street 1:8117 DAVIDSON DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-2577
Mailing Address - Country:US
Mailing Address - Phone:214-335-5116
Mailing Address - Fax:
Practice Address - Street 1:11955 DALLAS PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:214-705-0550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty