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General NPI Number Information
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NPI Number | 1447375704
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS ORTHODONTIC ASSOCIATES, P.A.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 N ALMA DR SUITE 102
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City | ALLEN
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State | TX
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Zip | 75013-3337
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Country | US
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Telephone | 972-727-7486
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Fax | 972-727-0970
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Provider Business Mailing Address
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Address Line | 201 N ALMA DR SUITE 102
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City | ALLEN
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State | TX
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Zip | 75013-3337
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Country | US
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Telephone | 972-727-7486
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Fax | 972-727-0970
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Authorized Official
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Title or Position | MANAGER
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Name | LISA BEATY
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Credential |
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Telephone | 972-727-7486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 18244
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License Number State | PR
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