Provider Demographics
NPI:1093338998
Name:DRINKWATER, KRISTEN (DMD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:DRINKWATER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9904 MONASTERY DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6579
Mailing Address - Country:US
Mailing Address - Phone:254-383-3411
Mailing Address - Fax:
Practice Address - Street 1:4685 ELDORADO PKWY STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-0290
Practice Address - Country:US
Practice Address - Phone:469-445-2687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX361431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice