Provider Demographics
NPI:1114327319
Name:TRI DENTAL PLLC
Entity Type:Organization
Organization Name:TRI DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-845-7879
Mailing Address - Street 1:5757 WARREN PKWY
Mailing Address - Street 2:220
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4274
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5757 WARREN PKWY
Practice Address - Street 2:220
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4274
Practice Address - Country:US
Practice Address - Phone:817-845-7879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty