Provider Demographics
NPI:1184929176
Name:SONIA LOUCA, DDS, PLLC
Entity type:Organization
Organization Name:SONIA LOUCA, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LOUCA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-462-8655
Mailing Address - Street 1:220 S DENTON TAP RD STE 104
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5098
Mailing Address - Country:US
Mailing Address - Phone:972-462-8655
Mailing Address - Fax:
Practice Address - Street 1:220 S DENTON TAP RD STE 104
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-5098
Practice Address - Country:US
Practice Address - Phone:972-462-8655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX197211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty