Provider Demographics
NPI:1245665454
Name:DENTAL ASSOCIATES OF NORTH TEXAS PA
Entity type:Organization
Organization Name:DENTAL ASSOCIATES OF NORTH TEXAS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:PALYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-665-2834
Mailing Address - Street 1:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76241-0696
Mailing Address - Country:US
Mailing Address - Phone:940-665-2834
Mailing Address - Fax:940-665-2941
Practice Address - Street 1:509 E ELM ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-4132
Practice Address - Country:US
Practice Address - Phone:940-665-2834
Practice Address - Fax:940-665-2941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6659302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization