Provider Demographics
NPI:1073070066
Name:TODAY DENTAL OF MANSFIELD NORTH PLLC
Entity Type:Organization
Organization Name:TODAY DENTAL OF MANSFIELD NORTH PLLC
Other - Org Name:TODAY DENTAL OF MANSFIELD NORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:817-318-6329
Mailing Address - Street 1:520 E VINE ST UNIT 484
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76244-3821
Mailing Address - Country:US
Mailing Address - Phone:817-318-6329
Mailing Address - Fax:
Practice Address - Street 1:1200 HIGHWAY 287 N STE 101
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2874
Practice Address - Country:US
Practice Address - Phone:817-453-4075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty