Provider Demographics
NPI:1508262791
Name:UDC BUCKNER BLVD,, PLLC
Entity Type:Organization
Organization Name:UDC BUCKNER BLVD,, PLLC
Other - Org Name:UNIVERSAL DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CORAY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PREECE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-248-2958
Mailing Address - Street 1:426 S BUCKNER BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-6521
Mailing Address - Country:US
Mailing Address - Phone:469-248-2958
Mailing Address - Fax:469-248-2875
Practice Address - Street 1:426 S BUCKNER BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-6521
Practice Address - Country:US
Practice Address - Phone:469-248-2958
Practice Address - Fax:469-248-2875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-14
Last Update Date:2014-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty