Organization
ODP OF TEXAS ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE CARIDE (CREDENTIALING MANAGER)
(470) 207-3264
Entity
Organization
Contact information
Practice address
10920 FRY RD STE 650, CYPRESS, TX 77433-4147
(281) 373-5437
Mailing address
2300 LAKEVIEW PKWY STE 250, ALPHARETTA, GA 30009-3954
(470) 207-3264
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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