Organization
ODP OF TEXAS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE CARIDE (CREDENTIALING)
(727) 784-2721
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
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/03/2022
Last updated
08/12/2022
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