MEDICARE: E LINE ORTHODONTICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	27128	TX

General Provider Information

NPI Number	:	1700146966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E LINE ORTHODONTICS

Provider Business Mailing Address
First Line	:	1017 E TRINITY MILLS RD
Second Line	:	102
City	:	CARROLLTON
State	:	TX
Zip	:	75006-1438
Country	:	US
Telephone Number	:	972-242-2040
Fax Number	:	972-446-0088

Provider Business Practice Location Address
First Line	:	3044 OLD DENTON RD
Second Line	:	STE. 111-304
City	:	CARROLLTON
State	:	TX
Zip	:	75007-5016
Country	:	US
Telephone Number	:	972-242-2040
Fax Number	:	972-446-0088

Authorized Official
Title or Position	:	OWNER
Name	:	YOON H. CHANG
Credential	:	D.D.S
Telephone Number	:	972-242-2040

Provider Enumeration Date	:	05/22/2012
Last Update Date	:	05/22/2012

Similar Medicare Providers

1093711285 — DR. SIMON LIM M.D.
Practice Location Address:

3044 OLD DENTON RD , SUITE 115
CARROLLTON, TX
75007-5016

Practice Phone: 972-245-2876
Practice Fax: 972-905-7487

1952343584 — JAMJEN ENTERPRISES INCORPORATED
Practice Location Address:

3044 OLD DENTON RD , SUITE #115
CARROLLTON, TX
75007-5016

Practice Phone: 972-820-1044
Practice Fax: 972-820-1046

1528093796 — DR. SUZAN JO SMITH DC
Practice Location Address:

3044 OLD DENTON RD , #316
CARROLLTON, TX
75007-5016

Practice Phone: 972-245-3377
Practice Fax: 972-245-6366

1659413706 — HUN K. LEE M.D.
Practice Location Address:

3044 OLD DENTON RD , 317
CARROLLTON, TX
75007-5016

Practice Phone: 972-242-3361
Practice Fax:

1598985004 — DR. SUZAN J. SMITH CHIROPRACTIC PA
Practice Location Address:

3044 OLD DENTON RD , SUITE 316
CARROLLTON, TX
75007-5016

Practice Phone: 972-245-3377
Practice Fax: 972-245-6366

1386835569 — DR. ELIZABETH RACHEL THOMAS DO
Practice Location Address:

3044 OLD DENTON RD , SUITE 138
CARROLLTON, TX
75007-5016

Practice Phone: 972-245-0007
Practice Fax: 972-245-9272

Directions to “E LINE ORTHODONTICS ” Practice Location

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