Provider Demographics
NPI:1912378837
Name:TMJ & SLEEP THERAPY CENTRE OF NORTH TEXAS, LLC
Entity Type:Organization
Organization Name:TMJ & SLEEP THERAPY CENTRE OF NORTH TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAB
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRISH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, DABCP, DABC
Authorized Official - Phone:972-538-3777
Mailing Address - Street 1:1005 LONG PRAIRIE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022
Mailing Address - Country:US
Mailing Address - Phone:972-538-3777
Mailing Address - Fax:972-538-3771
Practice Address - Street 1:1005 LONG PRAIRIE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022
Practice Address - Country:US
Practice Address - Phone:972-538-3777
Practice Address - Fax:972-538-3771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty