Provider Demographics
NPI:1508526732
Name:TEXAS TINY TEETH ORTHODONTICS
Entity Type:Organization
Organization Name:TEXAS TINY TEETH ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAUGHTER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-207-0302
Mailing Address - Street 1:11700 TEEL PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-2056
Mailing Address - Country:US
Mailing Address - Phone:469-850-5560
Mailing Address - Fax:
Practice Address - Street 1:11700 TEEL PKWY STE 301
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-2056
Practice Address - Country:US
Practice Address - Phone:469-850-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty