Provider Demographics
NPI:1073052411
Name:BRITEX DENTAL OF CEDAR PARK PLLC
Entity Type:Organization
Organization Name:BRITEX DENTAL OF CEDAR PARK PLLC
Other - Org Name:WALDEN DENTAL CEDAR PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:518-526-2968
Mailing Address - Street 1:5001 183A TOLL RD
Mailing Address - Street 2:SUITE R300
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7903
Mailing Address - Country:US
Mailing Address - Phone:512-362-7130
Mailing Address - Fax:512-362-7132
Practice Address - Street 1:5001 183A TOLL RD
Practice Address - Street 2:SUITE R300
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7903
Practice Address - Country:US
Practice Address - Phone:512-362-7130
Practice Address - Fax:512-362-7132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24472122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty