Provider Demographics
NPI:1811380991
Name:MINT DENTISTRY, PLLC
Entity Type:Organization
Organization Name:MINT DENTISTRY, PLLC
Other - Org Name:IRVING MINT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-335-0633
Mailing Address - Street 1:3201 W AIRPORT FREEWAY STE 102
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062
Mailing Address - Country:US
Mailing Address - Phone:972-893-8730
Mailing Address - Fax:469-619-6941
Practice Address - Street 1:4000 N MACARTHUR BLVD STE A116
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6418
Practice Address - Country:US
Practice Address - Phone:214-821-6468
Practice Address - Fax:972-893-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental