Provider Demographics
NPI:1639255474
Name:NETWORK PROVIDER ASSOCIATES
Entity Type:Organization
Organization Name:NETWORK PROVIDER ASSOCIATES
Other - Org Name:FOREST PARK DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-755-0800
Mailing Address - Street 1:17300 DALLAS PKWY
Mailing Address - Street 2:STE 1070
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1145
Mailing Address - Country:US
Mailing Address - Phone:972-755-0800
Mailing Address - Fax:972-755-0890
Practice Address - Street 1:9550 FOREST LN
Practice Address - Street 2:SUITE 700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5905
Practice Address - Country:US
Practice Address - Phone:214-348-5505
Practice Address - Fax:214-348-9363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX184581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty