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General NPI Number Information
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NPI Number | 1528534773
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Entity Type | Organization
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Legal Business Name | DALLAS DENTAL ASSOCIATES - SAVANNAH PLLC
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Dates
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Enumeration Date | 10/15/2018
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 26795 US HIGHWAY 380 E STE 400
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City | AUBREY
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State | TX
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Zip | 76227-7895
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Country | US
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Telephone | 972-347-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 26795 US HIGHWAY 380 E STE 400
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City | AUBREY
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State | TX
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Zip | 76227-7895
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Country | US
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Telephone | 972-347-6200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN J. WINGFIELD
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Credential | DMD
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Telephone | 678-906-1769
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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