Provider Demographics
NPI:1023432531
Name:CHRYSALIS DENTAL ARTS PLLC
Entity type:Organization
Organization Name:CHRYSALIS DENTAL ARTS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-298-4191
Mailing Address - Street 1:403 W WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4619
Mailing Address - Country:US
Mailing Address - Phone:972-298-4191
Mailing Address - Fax:972-298-3290
Practice Address - Street 1:403 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4619
Practice Address - Country:US
Practice Address - Phone:972-298-4191
Practice Address - Fax:972-298-3290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental