Provider Demographics
NPI:1427334887
Name:ROOT CANAL CLINIC OF NORTH TEXAS
Entity type:Organization
Organization Name:ROOT CANAL CLINIC OF NORTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YOGESH
Authorized Official - Middle Name:THAKOR
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-342-0425
Mailing Address - Street 1:2201 MARTIN DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6081
Mailing Address - Country:US
Mailing Address - Phone:817-438-2220
Mailing Address - Fax:271-439-6675
Practice Address - Street 1:2201 MARTIN DR STE 200
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6081
Practice Address - Country:US
Practice Address - Phone:817-438-2220
Practice Address - Fax:817-439-6675
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROOT CANAL CLINIC OF NORTH TEXAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201231223E0200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty