Provider Demographics
NPI:1184045288
Name:ADVANTAGE DENTISTRY OF CARROLLTON PLLC
Entity Type:Organization
Organization Name:ADVANTAGE DENTISTRY OF CARROLLTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:SARABJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KHASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-512-0285
Mailing Address - Street 1:3065 N JOSEY LN
Mailing Address - Street 2:SUITE 60
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5340
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3065 N JOSEY LN
Practice Address - Street 2:SUITE 60
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5340
Practice Address - Country:US
Practice Address - Phone:972-492-8888
Practice Address - Fax:972-492-3777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty