Provider Demographics
NPI:1518443613
Name:THE DENTAL HOUSE
Entity Type:Organization
Organization Name:THE DENTAL HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-782-0820
Mailing Address - Street 1:2785 BEE CAVES RD STE 331
Mailing Address - Street 2:
Mailing Address - City:ROLLINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5803
Mailing Address - Country:US
Mailing Address - Phone:512-782-0820
Mailing Address - Fax:
Practice Address - Street 1:2785 BEE CAVES RD STE 331
Practice Address - Street 2:
Practice Address - City:ROLLINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:78746-5803
Practice Address - Country:US
Practice Address - Phone:512-782-0820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental