Provider Demographics
NPI:1831528512
Name:MARKET STREET FAMILY DENTAL,PLLC
Entity type:Organization
Organization Name:MARKET STREET FAMILY DENTAL,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:CAPARAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-982-8492
Mailing Address - Street 1:5400 LBJ FWY
Mailing Address - Street 2:STE 944
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-1000
Mailing Address - Country:US
Mailing Address - Phone:972-982-8490
Mailing Address - Fax:972-982-8492
Practice Address - Street 1:2800 E WHITESTONE BLVD
Practice Address - Street 2:STE. 225
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7273
Practice Address - Country:US
Practice Address - Phone:512-337-0993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty