Provider Demographics
NPI:1023209194
Name:CHRIS S. POTTS, D.D.S.,P.A.
Entity Type:Organization
Organization Name:CHRIS S. POTTS, D.D.S.,P.A.
Other - Org Name:THE KIDS SPOT DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:870-648-5608
Mailing Address - Street 1:5489 SUMMERHILL RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4608
Mailing Address - Country:US
Mailing Address - Phone:903-223-7768
Mailing Address - Fax:903-223-6006
Practice Address - Street 1:5489 SUMMERHILL RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4608
Practice Address - Country:US
Practice Address - Phone:870-648-5608
Practice Address - Fax:903-223-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty