Provider Demographics
NPI:1811551690
Name:ORACLE INDUSTRIES
Entity Type:Organization
Organization Name:ORACLE INDUSTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-696-3082
Mailing Address - Street 1:8325 WALNUT HILL LN STE 111
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4212
Mailing Address - Country:US
Mailing Address - Phone:214-696-3082
Mailing Address - Fax:214-696-4607
Practice Address - Street 1:8325 WALNUT HILL LN STE 111
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4212
Practice Address - Country:US
Practice Address - Phone:214-696-3082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty