Provider Demographics
NPI:1588007819
Name:ENDODONTIC ASSOCIATES OF CARROLLTON PLLC
Entity Type:Organization
Organization Name:ENDODONTIC ASSOCIATES OF CARROLLTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOGESH
Authorized Official - Middle Name:T
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-342-0425
Mailing Address - Street 1:12655 N CENTRAL EXPY
Mailing Address - Street 2:1014
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1700
Mailing Address - Country:US
Mailing Address - Phone:214-342-0425
Mailing Address - Fax:
Practice Address - Street 1:4323 N JOSEY LN
Practice Address - Street 2:205
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4633
Practice Address - Country:US
Practice Address - Phone:972-394-0912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201231223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty