Most Relevant Information
Provider Data
| NPI Number: | 1003647132 |
| Provider Name: | BRENDA HERNANDEZ MOCTEZUMA |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/10/2024 |
| Last Updated: | 08/10/2024 |
Provider Practice Location
3302 GASTON AVE
DALLAS
TX
752462013
Practice Location Phone/Fax
| Phone: | 2148288100 |
| Fax: |
Provider Mailing Location
4221 ROSEHILL RD APT 2
GARLAND
TX
750432544
Provider Mailing Phone/Fax
| Phone: | 4694080203 |
| Fax: |