Provider Demographics
NPI:1659707933
Name:BRACKETS DENTAL PLLC
Entity Type:Organization
Organization Name:BRACKETS DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARABJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KHASSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-512-0285
Mailing Address - Street 1:15110 DALLAS PARKWAY
Mailing Address - Street 2:SUITE 470
Mailing Address - City:DALLAS TX
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-286-5711
Mailing Address - Fax:972-557-4668
Practice Address - Street 1:3501 SHEPHERD LANE
Practice Address - Street 2:
Practice Address - City:BALCH SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75180
Practice Address - Country:US
Practice Address - Phone:972-512-0285
Practice Address - Fax:972-239-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty