Provider Demographics
NPI:1114898129
Name:TSLL DENTAL PLLC
Entity type:Organization
Organization Name:TSLL DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAE
Authorized Official - Middle Name:EUN
Authorized Official - Last Name:YOU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-317-3322
Mailing Address - Street 1:3705 WALDEN DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5065
Mailing Address - Country:US
Mailing Address - Phone:415-317-3322
Mailing Address - Fax:
Practice Address - Street 1:1780 NORTHWEST HWY STE 150
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5283
Practice Address - Country:US
Practice Address - Phone:469-750-0830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental