Provider Demographics
NPI:1053552208
Name:DOSA PLANO, LLC
Entity type:Organization
Organization Name:DOSA PLANO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:214-392-8115
Mailing Address - Street 1:5824 W PLANO PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4630
Mailing Address - Country:US
Mailing Address - Phone:972-267-3223
Mailing Address - Fax:972-733-0567
Practice Address - Street 1:5824 W PLANO PKWY
Practice Address - Street 2:STE 101
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4630
Practice Address - Country:US
Practice Address - Phone:972-267-3223
Practice Address - Fax:972-733-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220761223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty