Provider Demographics
NPI:1417293044
Name:SEARS DDS PC
Entity Type:Organization
Organization Name:SEARS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEARS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:432-523-5405
Mailing Address - Street 1:1717 NE MUSTANG DR
Mailing Address - Street 2:
Mailing Address - City:ANDREWS
Mailing Address - State:TX
Mailing Address - Zip Code:79714-3640
Mailing Address - Country:US
Mailing Address - Phone:432-523-5405
Mailing Address - Fax:432-523-6605
Practice Address - Street 1:1717 NE MUSTANG DR
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:TX
Practice Address - Zip Code:79714-3640
Practice Address - Country:US
Practice Address - Phone:432-523-5405
Practice Address - Fax:432-523-6605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty