Provider Demographics
NPI:1831424134
Name:SOUTHWEST CROSSING DENTAL PC
Entity type:Organization
Organization Name:SOUTHWEST CROSSING DENTAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-864-1220
Mailing Address - Street 1:2240 MARKET PLACE BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-8072
Mailing Address - Country:US
Mailing Address - Phone:972-556-0600
Mailing Address - Fax:972-759-9824
Practice Address - Street 1:2205 W I 20
Practice Address - Street 2:STE 100
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3946
Practice Address - Country:US
Practice Address - Phone:972-556-0600
Practice Address - Fax:972-759-9824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23674122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty