Provider Demographics
NPI:1356595201
Name:PARK CITIES DENTAL GROUP LLP
Entity type:Organization
Organization Name:PARK CITIES DENTAL GROUP LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-528-7870
Mailing Address - Street 1:3110 WEBB AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3445
Mailing Address - Country:US
Mailing Address - Phone:214-528-7870
Mailing Address - Fax:214-526-1761
Practice Address - Street 1:3110 WEBB AVE STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3445
Practice Address - Country:US
Practice Address - Phone:214-528-7870
Practice Address - Fax:214-526-1761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty