Provider Demographics
NPI:1902428741
Name:ARISE DENTAL OF CARTHAGE PLLC
Entity type:Organization
Organization Name:ARISE DENTAL OF CARTHAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VINEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-200-1114
Mailing Address - Street 1:1100 W PANOLA ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75633-2342
Mailing Address - Country:US
Mailing Address - Phone:903-200-1114
Mailing Address - Fax:903-500-2703
Practice Address - Street 1:1100 W PANOLA ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633-2342
Practice Address - Country:US
Practice Address - Phone:903-200-1114
Practice Address - Fax:903-500-2703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX30165OtherTEXAS STATE BOARD OF DENTAL EXAMINERS