Provider Demographics
NPI:1396577219
Name:SDR PEDIATRIC DENTISTRY PLLC
Entity type:Organization
Organization Name:SDR PEDIATRIC DENTISTRY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SNEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-778-0224
Mailing Address - Street 1:227 ZACHARY WALK
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3791
Mailing Address - Country:US
Mailing Address - Phone:817-778-0224
Mailing Address - Fax:
Practice Address - Street 1:833 E NORTHWEST HWY STE 100
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3302
Practice Address - Country:US
Practice Address - Phone:817-778-0224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty