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General NPI Number Information
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NPI Number | 1760169825
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Entity Type | Organization
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Legal Business Name | TERRELL TINY TEETH PLLC
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 1270 FM-148
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City | TERRELL
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State | TX
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Zip | 75160
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Country | US
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Telephone | 469-769-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 11700 TEEL PKWY STE 301
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City | FRISCO
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State | TX
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Zip | 75033-2056
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Country | US
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Telephone | 469-850-5560
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES SLAUGHTER III
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Credential | DDS
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Telephone | 225-288-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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