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Organization
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Active
Organization
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Active
Parent organization
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Other names
Sealy Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Authorized official
SILAS CHARLES ERICKSON (CREDENTIALING SPECIALIST)
(720) 353-4903
Entity
Organization
Contact information
Practice address
2355 HIGHWAY 36 S, SEALY, TX 77474-4224
(719) 266-2717
Mailing address
6110 BARNES RD, COLORADO SPRINGS, CO 80922-2600
(719) 266-2717
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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