Provider Demographics
NPI:1063818243
Name:UDC FIRST STREET, PLLC
Entity Type:Organization
Organization Name:UDC FIRST STREET, PLLC
Other - Org Name:UNIVERSAL DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CORAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PREECE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-487-1500
Mailing Address - Street 1:107 N 1ST ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-6539
Mailing Address - Country:US
Mailing Address - Phone:972-487-1500
Mailing Address - Fax:972-487-1575
Practice Address - Street 1:107 N 1ST ST
Practice Address - Street 2:SUITE B
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-6539
Practice Address - Country:US
Practice Address - Phone:972-487-1500
Practice Address - Fax:972-487-1575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty