Provider Demographics
NPI:1114032422
Name:FAMILY DENTISTRY OF HUNTSVILLE
Entity Type:Organization
Organization Name:FAMILY DENTISTRY OF HUNTSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:936-295-3709
Mailing Address - Street 1:901 NORMAL PARK
Mailing Address - Street 2:#200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77320
Mailing Address - Country:US
Mailing Address - Phone:936-295-3709
Mailing Address - Fax:936-295-0142
Practice Address - Street 1:901 NORMAL PARK
Practice Address - Street 2:#200
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77320
Practice Address - Country:US
Practice Address - Phone:936-295-3709
Practice Address - Fax:936-295-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111691223G0001X
TX169031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84D567OtherBLUE CROSS BLUE SHIELD
TX84D566OtherBLUE CROSS BLUE SHIELD