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NPI 1568471233

NPI 1568471233 : JOE W POTTER DDS : CEDAR HILL, TX

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General NPI Number Information
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    NPI Number           |    1568471233
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    Entity Type          |    Individual 
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    Provider Name        |    JOE W POTTER DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/05/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    207 W BELT LINE RD 
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    City                 |    CEDAR HILL
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    State                |    TX
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    Zip                  |    75104-2066
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    Country              |    US
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    Telephone            |    972-291-1501
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    Fax                  |    972-291-1503
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Provider Business Mailing Address
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    Address Line         |    815 KNOLL MANOR CT 
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    City                 |    CEDAR HILL
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    State                |    TX
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    Zip                  |    75104-7807
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    Country              |    US
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    Telephone            |    972-291-1501
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    Fax                  |    972-291-1503
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    10071
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    License Number State |    TX
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