Provider Demographics
NPI:1568855435
Name:ROWLETT DENTIST PLLC
Entity Type:Organization
Organization Name:ROWLETT DENTIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:POOSKOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-401-4900
Mailing Address - Street 1:8701 LIBERTY GROVE RD
Mailing Address - Street 2:STE 50
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-2301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8701 LIBERTY GROVE RD
Practice Address - Street 2:STE 50
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75089-2301
Practice Address - Country:US
Practice Address - Phone:972-401-4900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes125K00000XDental ProvidersAdvanced Practice Dental TherapistGroup - Single Specialty