Provider Demographics
NPI:1467097782
Name:DENTISTS OF WHITE ROCK, PC
Entity Type:Organization
Organization Name:DENTISTS OF WHITE ROCK, PC
Other - Org Name:DENTISTS OF WHITE ROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEETHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ZWICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-217-4136
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 1:9323 GARLAND RD STE 105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3675
Practice Address - Country:US
Practice Address - Phone:214-217-4136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-11
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty