Provider Demographics
NPI:1518130749
Name:PRESTON CAMPBELL DENTAL
Entity Type:Organization
Organization Name:PRESTON CAMPBELL DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-233-9399
Mailing Address - Street 1:17194 PRESTON RD
Mailing Address - Street 2:SUITE 224
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248
Mailing Address - Country:US
Mailing Address - Phone:972-233-9399
Mailing Address - Fax:972-233-9437
Practice Address - Street 1:17194 PRESTON RD
Practice Address - Street 2:SUITE 224
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248
Practice Address - Country:US
Practice Address - Phone:972-233-9399
Practice Address - Fax:972-233-9437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty