Provider Demographics
NPI:1528534773
Name:DALLAS DENTAL ASSOCIATES - SAVANNAH PLLC
Entity Type:Organization
Organization Name:DALLAS DENTAL ASSOCIATES - SAVANNAH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINGFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:678-906-1769
Mailing Address - Street 1:26795 US HIGHWAY 380 E STE 400
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-7895
Mailing Address - Country:US
Mailing Address - Phone:972-347-6200
Mailing Address - Fax:
Practice Address - Street 1:26795 US HIGHWAY 380 E STE 400
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-7895
Practice Address - Country:US
Practice Address - Phone:972-347-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty