Provider Demographics
NPI:1023612918
Name:THRIVE DENTAL SACHSE PLLC
Entity type:Organization
Organization Name:THRIVE DENTAL SACHSE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-898-3102
Mailing Address - Street 1:5822 VICKERY BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6336
Mailing Address - Country:US
Mailing Address - Phone:323-898-3102
Mailing Address - Fax:
Practice Address - Street 1:7900 WOODBRIDGE PKWY
Practice Address - Street 2:#200
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048
Practice Address - Country:US
Practice Address - Phone:323-898-3102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty