Provider Demographics
NPI:1427226166
Name:PRICE, DWIGHT (DDS)
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:
Last Name:PRICE
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 1:14441 MEMORIAL DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-6744
Mailing Address - Country:US
Mailing Address - Phone:281-493-1550
Mailing Address - Fax:281-493-1568
Practice Address - Street 1:14441 MEMORIAL DR
Practice Address - Street 2:SUITE 11
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-6737
Practice Address - Country:US
Practice Address - Phone:281-493-1550
Practice Address - Fax:281-493-1568
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist