Provider First Line Business Practice Location Address:
1919 S SHILOH RD STE 400
Provider Second Line Business Practice Location Address:
TROPHY DENTAL OF GARLAND
Provider Business Practice Location Address City Name:
GARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75042-8211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-271-1581
Provider Business Practice Location Address Fax Number:
972-272-3176
Provider Enumeration Date:
11/21/2006