Provider Demographics
NPI:1467004192
Name:DENTISTS OF HUDSON OAKS AND ORTHODONTICS, PC
Entity Type:Organization
Organization Name:DENTISTS OF HUDSON OAKS AND ORTHODONTICS, PC
Other - Org Name:DENTISTS OF HUDSON OAKS AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-717-9653
Mailing Address - Street 1:PO BOX 920050
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75392-0050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HUDSON OAKS DRIVE
Practice Address - Street 2:SUITE 126
Practice Address - City:HUDSON OAKS
Practice Address - State:TX
Practice Address - Zip Code:76087
Practice Address - Country:US
Practice Address - Phone:817-717-9653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty