Provider Demographics
NPI:1154727089
Name:ARGYLE DENTAL ASSOCIATES, PA
Entity type:Organization
Organization Name:ARGYLE DENTAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-464-6664
Mailing Address - Street 1:136 OLD TOWN BLVD. N.
Mailing Address - Street 2:STE 100
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226
Mailing Address - Country:US
Mailing Address - Phone:940-464-6664
Mailing Address - Fax:940-464-4535
Practice Address - Street 1:136 OLD TOWN BLVD. N.
Practice Address - Street 2:STE 100
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226
Practice Address - Country:US
Practice Address - Phone:940-464-6664
Practice Address - Fax:940-464-4535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental