RESTORE DENTAL PLLC NPI 1104215367

NPI Information

NPI: 1104215367
Provider Name: RESTORE DENTAL PLLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
3108 W STATE HIGHWAY 22
CORSICANA, TX
ZIP 75110
Phone: (903) 257-8815
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RESTORE DENTAL PLLC is a dental clinic center in Corsicana, TX. RESTORE DENTAL PLLC NPI is 1104215367. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

3108 W STATE HIGHWAY 22
CORSICANA, TX
ZIP 75110-435
Phone: (903) 257-8815
Fax: (903) 900-4184

The provider's authorized official is Mahesh B. Gondi .
The authorized official title is President and has the following contact phone number (903) 257-8815.

The enumeration date for this NPI number is 1/12/2015 and was last updated on 1/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	22213	TEXAS	No
2	261QD0000X	Clinic/Center	Dental	22213	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1306909080	OTHER	TEXAS	NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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