Provider Demographics
NPI:1437896750
Name:PRODUCTIVE IMPRESSIONS DENTAL,PLLC
Entity Type:Organization
Organization Name:PRODUCTIVE IMPRESSIONS DENTAL,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DORIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-733-2107
Mailing Address - Street 1:3728 BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2449
Mailing Address - Country:US
Mailing Address - Phone:214-733-2107
Mailing Address - Fax:
Practice Address - Street 1:4940 W UNIVERSITY DR STE 40
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9912
Practice Address - Country:US
Practice Address - Phone:214-733-2107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty