Provider Demographics
NPI:1326053737
Name:DENTON CHIROPRACTIC CENTER, INC
Entity Type:Organization
Organization Name:DENTON CHIROPRACTIC CENTER, INC
Other - Org Name:LEWISVILLE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:NOELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:940-566-3232
Mailing Address - Street 1:1432 UNDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-7002
Mailing Address - Country:US
Mailing Address - Phone:940-566-3232
Mailing Address - Fax:940-382-1604
Practice Address - Street 1:1432 UNDERWOOD ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-7002
Practice Address - Country:US
Practice Address - Phone:940-566-3232
Practice Address - Fax:940-382-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0041JVOtherBLUE CROSS
TX00685ZMedicare ID - Type Unspecified