Provider Demographics
NPI:1194198895
Name:ENCORE DAP FRISCO, PLLC
Entity Type:Organization
Organization Name:ENCORE DAP FRISCO, PLLC
Other - Org Name:DENTAL ARTS OF FRISCO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PC SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-335-3131
Mailing Address - Street 1:5858 W. MAIN ST #250
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033
Mailing Address - Country:US
Mailing Address - Phone:972-335-3131
Mailing Address - Fax:
Practice Address - Street 1:5858 W. MAIN ST #250
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033
Practice Address - Country:US
Practice Address - Phone:972-335-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX12072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty