Provider Demographics
NPI:1730262965
Name:SIX DAY DENTAL & ORTHODONTICS N TEXAS PA
Entity type:Organization
Organization Name:SIX DAY DENTAL & ORTHODONTICS N TEXAS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS OWNER CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:U
Authorized Official - Last Name:BOND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-635-1105
Mailing Address - Street 1:120 S DENTON TAP
Mailing Address - Street 2:STE 100
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:469-635-1105
Mailing Address - Fax:469-635-1107
Practice Address - Street 1:200 E HWY 1114
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262
Practice Address - Country:US
Practice Address - Phone:817-567-8040
Practice Address - Fax:817-567-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16129122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty