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General NPI Number Information
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NPI Number | 1285762575
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Entity Type | Organization
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Legal Business Name | DENTAL VISIONS, P.A.
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 312 E RENFRO ST #204
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City | BURLESON
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State | TX
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Zip | 76028-3947
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Country | US
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Telephone | 817-295-7116
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Fax | 817-295-1404
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Provider Business Mailing Address
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Address Line | 312 E RENFRO ST #204
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City | BURLESON
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State | TX
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Zip | 76028-3947
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Country | US
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Telephone | 817-295-7116
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Fax | 817-295-1404
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Authorized Official
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Title or Position | TREASURER
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Name | DR. STEVEN R TATE
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Credential | DDS
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Telephone | 817-295-7116
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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 | 13143
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License Number State | TX
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