Provider Demographics
NPI:1851954507
Name:KNIGHT DENTAL PLLC
Entity Type:Organization
Organization Name:KNIGHT DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:817-953-7700
Mailing Address - Street 1:381 MERCEDES ST
Mailing Address - Street 2:
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-2593
Mailing Address - Country:US
Mailing Address - Phone:817-953-7700
Mailing Address - Fax:
Practice Address - Street 1:381 MERCEDES ST
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-2593
Practice Address - Country:US
Practice Address - Phone:817-953-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNIGHT DENTAL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty