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General NPI Number Information
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NPI Number | 1396046991
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Entity Type | Organization
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Legal Business Name | K2 ENDODONTICS, P.A.
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Dates
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Enumeration Date | 11/12/2010
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Last Update Date | 11/12/2010
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Provider Practice Location Address
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Address Line | 107 SUNCREEK DR STE 120
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City | ALLEN
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State | TX
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Zip | 75013-3672
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Country | US
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Telephone | 214-547-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 107 SUNCREEK DR STE 120
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City | ALLEN
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State | TX
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Zip | 75013-3672
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Country | US
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Telephone | 214-547-9111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAVITA DODDAMANE
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Credential | DDS, MS
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Telephone | 214-801-8230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 20549
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License Number State | TX
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