Provider Demographics
NPI:1437357894
Name:DOUGLAS P. SINN, DDS, PA
Entity Type:Organization
Organization Name:DOUGLAS P. SINN, DDS, PA
Other - Org Name:ADVANCED FACIAL & ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OF BUSINESS
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:SINN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-225-3223
Mailing Address - Street 1:1752 BROAD PARK CIR N
Mailing Address - Street 2:#100
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7821
Mailing Address - Country:US
Mailing Address - Phone:817-225-3223
Mailing Address - Fax:817-225-0242
Practice Address - Street 1:1752 BROAD PARK CIR N
Practice Address - Street 2:#100
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7821
Practice Address - Country:US
Practice Address - Phone:817-225-3223
Practice Address - Fax:817-225-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty