Provider Demographics
NPI:1326283359
Name:HIGHLAND PARK ENDODONTICS
Entity Type:Organization
Organization Name:HIGHLAND PARK ENDODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:F
Authorized Official - Last Name:NE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-528-7668
Mailing Address - Street 1:7001 PRESTON RD STE 301A
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-5104
Mailing Address - Country:US
Mailing Address - Phone:214-528-7668
Mailing Address - Fax:214-528-3065
Practice Address - Street 1:7001 PRESTON RD
Practice Address - Street 2:SUITE 301-A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-1190
Practice Address - Country:US
Practice Address - Phone:214-528-7668
Practice Address - Fax:214-528-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty