Provider Demographics
NPI:1073374914
Name:TEXAS DENTAL SLEEP SERVICES PLLC
Entity Type:Organization
Organization Name:TEXAS DENTAL SLEEP SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:833-275-3372
Mailing Address - Street 1:12225 GREENVILLE AVE. #110
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243
Mailing Address - Country:US
Mailing Address - Phone:512-636-8120
Mailing Address - Fax:512-338-8192
Practice Address - Street 1:12221 MERIT DRIVE 3 FOREST TOWERS #470
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251
Practice Address - Country:US
Practice Address - Phone:512-636-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS DENTAL SLEEP SERVICES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty