Provider Demographics
NPI:1033863238
Name:ADVANCED PROSTHETIC RESTORATIONS
Entity Type:Organization
Organization Name:ADVANCED PROSTHETIC RESTORATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED CLINICAL ANAPLASTOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:MAMS, CCA
Authorized Official - Phone:972-696-9497
Mailing Address - Street 1:PO BOX 261684
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75026-1684
Mailing Address - Country:US
Mailing Address - Phone:972-696-9497
Mailing Address - Fax:469-409-6142
Practice Address - Street 1:2213 MCDERMOTT RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-4613
Practice Address - Country:US
Practice Address - Phone:972-696-9497
Practice Address - Fax:469-409-6142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologistGroup - Single Specialty