Provider Demographics
NPI:1568985299
Name:PHD LAS COLINAS, PLLC
Entity Type:Organization
Organization Name:PHD LAS COLINAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PINCUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-416-2330
Mailing Address - Street 1:5961 DALLAS PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8519
Mailing Address - Country:US
Mailing Address - Phone:972-416-2330
Mailing Address - Fax:
Practice Address - Street 1:580 DECKER DR STE 275
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-2377
Practice Address - Country:US
Practice Address - Phone:972-579-1046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty