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General NPI Number Information
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NPI Number | 1215263199
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Entity Type | Organization
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Legal Business Name | DANNY PAUL WINDHAM DDS PC
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Dates
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Enumeration Date | 10/27/2009
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 406 CORA ST
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City | CENTER
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State | TX
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Zip | 75935-3611
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Country | US
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Telephone | 936-598-2923
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Fax | 936-598-6412
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Provider Business Mailing Address
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Address Line | 406 CORA ST
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City | CENTER
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State | TX
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Zip | 75935-3610
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Country | US
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Telephone | 936-598-2923
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Fax | 936-598-6412
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. SALLY JANICE WINDHAM
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Credential |
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Telephone | 936-598-2923
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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 | 23976
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 23935
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12393
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License Number State | TX
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