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General NPI Number Information
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NPI Number | 1023209194
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Entity Type | Organization
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Legal Business Name | CHRIS S. POTTS, D.D.S.,P.A.
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 5489 SUMMERHILL RD
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City | TEXARKANA
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State | TX
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Zip | 75503-4608
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Country | US
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Telephone | 870-648-5608
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Fax | 903-223-6006
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Provider Business Mailing Address
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Address Line | 5489 SUMMERHILL RD
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City | TEXARKANA
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State | TX
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Zip | 75503-4608
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Country | US
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Telephone | 903-223-7768
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Fax | 903-223-6006
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. CHRIS S. POTTS
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Credential | D.D.S., P.A.
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Telephone | 870-648-5608
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 21888
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License Number State | TX
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