Provider Demographics
NPI:1760632251
Name:FLOSS DENTISTRY-UPTOWN
Entity Type:Organization
Organization Name:FLOSS DENTISTRY-UPTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE CO-ORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SPITTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-978-0101
Mailing Address - Street 1:3131 LEMMON AVE E
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1411
Mailing Address - Country:US
Mailing Address - Phone:214-978-0101
Mailing Address - Fax:214-978-0121
Practice Address - Street 1:3131 LEMMON AVE E
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1411
Practice Address - Country:US
Practice Address - Phone:214-978-0101
Practice Address - Fax:214-978-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty