Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 37856 | TX |
NPI | 1093487803 |
---|---|
Provider Name | Dr. Fernando Marques Da Cunha |
First Address | Dallas, TX 75204-4168 |
Second Address | Frisco, TX 75035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2021 |
Last Update Date | 30/09/2021 |