Provider Demographics
NPI:1104428622
Name:TM2 DENTAL ,PLLC
Entity type:Organization
Organization Name:TM2 DENTAL ,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISA
Authorized Official - Middle Name:ANTOINETTE
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-438-2121
Mailing Address - Street 1:21477 STATE HIGHWAY 46 W STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6797
Mailing Address - Country:US
Mailing Address - Phone:830-438-2121
Mailing Address - Fax:830-438-2121
Practice Address - Street 1:21477 STATE HIGHWAY 46 W STE 101
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6797
Practice Address - Country:US
Practice Address - Phone:830-438-2121
Practice Address - Fax:830-438-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental