Provider Demographics
NPI:1033502158
Name:DEVIN GNEITING DMD PLLC
Entity Type:Organization
Organization Name:DEVIN GNEITING DMD PLLC
Other - Org Name:KILLEEN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GNEITING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:254-519-4700
Mailing Address - Street 1:1405 E ELMS RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-2810
Mailing Address - Country:US
Mailing Address - Phone:254-519-4700
Mailing Address - Fax:254-519-7649
Practice Address - Street 1:1405 E ELMS RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-2810
Practice Address - Country:US
Practice Address - Phone:254-519-4700
Practice Address - Fax:254-519-7649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty