Provider Demographics
NPI:1710796438
Name:NORTH TEXAS DENTAL REHABILITATION OPERATING ROOM SERVICES LLC
Entity type:Organization
Organization Name:NORTH TEXAS DENTAL REHABILITATION OPERATING ROOM SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLWEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-500-4143
Mailing Address - Street 1:1900 COTTON MILL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-7250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 COTTON MILL DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-7250
Practice Address - Country:US
Practice Address - Phone:214-500-4143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies