Provider Demographics
NPI:1487827135
Name:TOOTH TRANSITIONS PLLC
Entity Type:Organization
Organization Name:TOOTH TRANSITIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:DORSEY
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-423-0060
Mailing Address - Street 1:5723 N FOSTER RD STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-1238
Mailing Address - Country:US
Mailing Address - Phone:210-661-1352
Mailing Address - Fax:210-661-0355
Practice Address - Street 1:5723 N FOSTER RD STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78244-1238
Practice Address - Country:US
Practice Address - Phone:210-661-1352
Practice Address - Fax:210-661-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226851223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty