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General NPI Number Information
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NPI Number | 1699588350
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Entity Type | Organization
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Legal Business Name | TCOSDI TMJ PLLC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 3312 TEASLEY LN # 300
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City | DENTON
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State | TX
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Zip | 76210-8315
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Country | US
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Telephone | 972-436-1513
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Fax | 972-436-0618
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Provider Business Mailing Address
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Address Line | 651 CROSS TIMBERS RD STE 103
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City | FLOWER MOUND
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State | TX
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Zip | 75028-1300
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Country | US
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Telephone | 972-436-1513
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Fax | 972-436-0618
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Authorized Official
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Title or Position | OWNER
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Name | AARON VICKERS
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Credential | DDS, MD
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Telephone | 972-436-1513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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