Provider Demographics
NPI:1528622693
Name:TC DENTAL PA
Entity type:Organization
Organization Name:TC DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-608-1811
Mailing Address - Street 1:5938 W PARKER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6416
Mailing Address - Country:US
Mailing Address - Phone:972-608-1811
Mailing Address - Fax:
Practice Address - Street 1:5938 W PARKER RD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6416
Practice Address - Country:US
Practice Address - Phone:972-608-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty