Provider Demographics
NPI:1124022488
Name:DYER, JAMES R (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:DYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OLD TOWN BLVD. S. # 103
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-3958
Mailing Address - Country:US
Mailing Address - Phone:940-240-5400
Mailing Address - Fax:
Practice Address - Street 1:101 OLD TOWN BLVD. S. # 103
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-3958
Practice Address - Country:US
Practice Address - Phone:940-240-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2016-11-08
Deactivation Date:2006-03-28
Deactivation Code:
Reactivation Date:2006-06-23
Provider Licenses
StateLicense IDTaxonomies
TX103911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics