Provider Demographics
NPI:1508905530
Name:ENOKSEN, SIGURD (DDS)
Entity Type:Individual
Prefix:DR
First Name:SIGURD
Middle Name:
Last Name:ENOKSEN
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 1:1320 W DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-5344
Mailing Address - Country:US
Mailing Address - Phone:214-948-3035
Mailing Address - Fax:214-941-1665
Practice Address - Street 1:1320 W DAVIS ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-5344
Practice Address - Country:US
Practice Address - Phone:214-948-3035
Practice Address - Fax:214-941-1665
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice