Provider Demographics
NPI:1992398317
Name:PRIMROSE DENTAL PLLC
Entity Type:Organization
Organization Name:PRIMROSE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NISHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARONDEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-918-4470
Mailing Address - Street 1:3522 DENTON HWY
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117
Mailing Address - Country:US
Mailing Address - Phone:817-918-4470
Mailing Address - Fax:
Practice Address - Street 1:3522 DENTON HWY
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117
Practice Address - Country:US
Practice Address - Phone:408-306-6618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty