Provider Demographics
NPI:1649373242
Name:SUZANNE APPOLITO DDS PA
Entity type:Organization
Organization Name:SUZANNE APPOLITO DDS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:APPOLITO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-275-4720
Mailing Address - Street 1:3600 GUS THOMASSON
Mailing Address - Street 2:#127
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150
Mailing Address - Country:US
Mailing Address - Phone:214-275-4720
Mailing Address - Fax:214-275-6816
Practice Address - Street 1:3600 GUS THOMASSON
Practice Address - Street 2:#127
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150
Practice Address - Country:US
Practice Address - Phone:214-275-4720
Practice Address - Fax:214-275-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223PO221X122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty