Healthcare Provider Details

I. General information

NPI: 1053552208
Provider Name (Legal Business Name): DOSA PLANO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 03/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5824 W PLANO PKWY STE 101
PLANO TX
75093-4630
US

IV. Provider business mailing address

5824 W PLANO PKWY STE 101
PLANO TX
75093-4630
US

V. Phone/Fax

Practice location:
  • Phone: 972-267-3223
  • Fax: 972-733-0567
Mailing address:
  • Phone: 972-267-3223
  • Fax: 972-733-0567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22076
License Number StateTX

VIII. Authorized Official

Name: DR. STEVEN D SHERRY
Title or Position: SOLE MEMBER/OWNER
Credential: DDS, MD
Phone: 214-392-8115