Provider Demographics
NPI:1013390525
Name:DENTAL IMPRESSIONS PC
Entity Type:Organization
Organization Name:DENTAL IMPRESSIONS PC
Other - Org Name:RIDGE POINT DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:SWEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGPAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-862-3100
Mailing Address - Street 1:151 RIDGE POINT PKWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248
Mailing Address - Country:US
Mailing Address - Phone:214-862-3100
Mailing Address - Fax:
Practice Address - Street 1:3401 WOLFE CIR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-2227
Practice Address - Country:US
Practice Address - Phone:214-862-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22451122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty