Provider Demographics
NPI:1326166133
Name:LIDE, DIANE L (DDS)
Entity Type:Individual
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First Name:DIANE
Middle Name:L
Last Name:LIDE
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Gender:F
Credentials:DDS
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Mailing Address - Street 1:5225 INDEPENDENCE PKWY
Mailing Address - Street 2:STE. 300
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035
Mailing Address - Country:US
Mailing Address - Phone:972-377-8444
Mailing Address - Fax:972-377-8445
Practice Address - Street 1:5225 INDEPENDENCE PKWY
Practice Address - Street 2:STE. 300
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:972-377-8444
Practice Address - Fax:972-377-8445
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2023-09-19
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Provider Licenses
StateLicense IDTaxonomies
TX188201223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry