Organization
BIOLASE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM SEGAL LAT (OWNER)
(972) 608-5000
Entity
Organization
Contact information
Practice address
5960 W PARKER RD, STE 278. PMB 227, PLANO, TX 75093-7767
(972) 608-5000
Mailing address
5960 W PARKER RD, STE 278. PMB 227, PLANO, TX 75093-7767
(972) 608-5000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATO529
TX
Other
Enumeration date
09/22/2006
Last updated
04/20/2008
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