Provider Demographics
NPI:1033686308
Name:SYCAMORE SCHOOL PLLC
Entity Type:Organization
Organization Name:SYCAMORE SCHOOL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARCUP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-732-9341
Mailing Address - Street 1:3550 HULEN ST STE C
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6885
Mailing Address - Country:US
Mailing Address - Phone:817-732-9341
Mailing Address - Fax:
Practice Address - Street 1:3050 SYCAMORE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-7771
Practice Address - Country:US
Practice Address - Phone:817-732-9341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty