Provider Demographics
NPI:1275972150
Name:BEFORE 55 PLLC
Entity Type:Organization
Organization Name:BEFORE 55 PLLC
Other - Org Name:LEGACY TRAILS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-458-0862
Mailing Address - Street 1:4800 HEDGCOXE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2403
Mailing Address - Country:US
Mailing Address - Phone:214-227-1000
Mailing Address - Fax:
Practice Address - Street 1:4800 HEDGCOXE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2403
Practice Address - Country:US
Practice Address - Phone:214-227-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25789122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty