Provider Demographics
NPI:1801221791
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 PKWY
Mailing Address - Street 2:SUITE 470
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4635
Mailing Address - Country:US
Mailing Address - Phone:972-512-0285
Mailing Address - Fax:972-239-0755
Practice Address - Street 1:2220 COIT RD
Practice Address - Street 2:SUITE 570
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3797
Practice Address - Country:US
Practice Address - Phone:972-964-6500
Practice Address - Fax:972-964-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty