Provider Demographics
NPI:1154981983
Name:COE DENTISTRY PLLC
Entity type:Organization
Organization Name:COE DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ARDILA
Authorized Official - Last Name:COE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-444-6479
Mailing Address - Street 1:137 SH 121
Mailing Address - Street 2:STE 110
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:469-444-6479
Mailing Address - Fax:
Practice Address - Street 1:137 W STATE HIGHWAY 121 STE 110
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2912
Practice Address - Country:US
Practice Address - Phone:469-444-6479
Practice Address - Fax:469-359-6754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1558570283OtherNPPES