Provider Demographics
NPI:1447375704
Name:NORTH TEXAS ORTHODONTIC ASSOCIATES, P.A.
Entity type:Organization
Organization Name:NORTH TEXAS ORTHODONTIC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-727-7486
Mailing Address - Street 1:201 N ALMA DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3337
Mailing Address - Country:US
Mailing Address - Phone:972-727-7486
Mailing Address - Fax:972-727-0970
Practice Address - Street 1:201 N ALMA DR
Practice Address - Street 2:SUITE 102
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3337
Practice Address - Country:US
Practice Address - Phone:972-727-7486
Practice Address - Fax:972-727-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR182441223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty