Provider Demographics
NPI:1124217880
Name:RENFRO, ARTHUR FRED JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:FRED
Last Name:RENFRO
Suffix:JR
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 1:1101 W EAGLE DR STE A
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3721
Mailing Address - Country:US
Mailing Address - Phone:940-627-2778
Mailing Address - Fax:940-627-7104
Practice Address - Street 1:1101 W EAGLE DR STE A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3721
Practice Address - Country:US
Practice Address - Phone:940-627-2778
Practice Address - Fax:940-627-7104
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12614122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist