Provider Demographics
NPI:1013353630
Name:ESSENTIAL DENTAL CARE
Entity Type:Organization
Organization Name:ESSENTIAL DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCHUBERT
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SAPIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-641-2900
Mailing Address - Street 1:2950 W CAMP WISDOM RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-4459
Mailing Address - Country:US
Mailing Address - Phone:972-641-2900
Mailing Address - Fax:972-641-2904
Practice Address - Street 1:2950 W CAMP WISDOM RD
Practice Address - Street 2:SUITE 300
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-4459
Practice Address - Country:US
Practice Address - Phone:972-641-2900
Practice Address - Fax:972-641-2904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD20045122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty