Provider Demographics
NPI:1073785069
Name:K. MIKE DOSSETT, D.D.S., INC
Entity Type:Organization
Organization Name:K. MIKE DOSSETT, D.D.S., INC
Other - Org Name:DOSSETT DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MIKE
Authorized Official - Last Name:DOSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-960-0082
Mailing Address - Street 1:4550 W ELDORADO PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4432
Mailing Address - Country:US
Mailing Address - Phone:972-542-4141
Mailing Address - Fax:214-544-9315
Practice Address - Street 1:4550 W ELDORADO PKWY
Practice Address - Street 2:SUITE 107
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4432
Practice Address - Country:US
Practice Address - Phone:972-542-4141
Practice Address - Fax:214-544-9315
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K. MIKE DOSSETT, D.D.S., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty