Healthcare Provider Details
I. General information
NPI: 1669352266
Provider Name (Legal Business Name): ROSHARON FAMILY DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3331 MERIDIANA PKWY STE 700
ROSHARON TX
77583-4852
US
IV. Provider business mailing address
5800 N INTERSTATE 35 STE 205
DENTON TX
76207-1438
US
V. Phone/Fax
- Phone: 281-697-4353
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRAIG
COPELAND
Title or Position: DMD/OWNER
Credential:
Phone: 940-220-7833