Provider Demographics
NPI:1740960798
Name:TCOSDI NORTH DALLAS, PLLC
Entity type:Organization
Organization Name:TCOSDI NORTH DALLAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HODAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-436-0008
Mailing Address - Street 1:651 CROSS TIMBERS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1300
Mailing Address - Country:US
Mailing Address - Phone:972-436-1513
Mailing Address - Fax:972-436-0618
Practice Address - Street 1:14856 PRESTON RD STE 104
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-6844
Practice Address - Country:US
Practice Address - Phone:972-217-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty