Provider Demographics
NPI:1003329293
Name:PRESTON COMMONS DENTAL CARE PLLC
Entity Type:Organization
Organization Name:PRESTON COMMONS DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:STETLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-361-6302
Mailing Address - Street 1:8117 PRESTON RD
Mailing Address - Street 2:150 W
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-6332
Mailing Address - Country:US
Mailing Address - Phone:214-361-6302
Mailing Address - Fax:214-265-7022
Practice Address - Street 1:8117 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-6332
Practice Address - Country:US
Practice Address - Phone:214-361-6302
Practice Address - Fax:214-265-7022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental