Provider Demographics
NPI:1023526365
Name:J&L DENTAL GROUP, PLLC
Entity type:Organization
Organization Name:J&L DENTAL GROUP, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:MCPHEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-673-1100
Mailing Address - Street 1:8925 HAAS DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-9126
Mailing Address - Country:US
Mailing Address - Phone:801-673-1100
Mailing Address - Fax:817-768-2277
Practice Address - Street 1:2401 HERITAGE TRACE PARKWAY
Practice Address - Street 2:SUITE 121
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177
Practice Address - Country:US
Practice Address - Phone:817-210-6062
Practice Address - Fax:817-768-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental