Provider Demographics
NPI:1740426659
Name:G. STAN PREECE, DDS
Entity Type:Organization
Organization Name:G. STAN PREECE, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:PREECE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-741-6100
Mailing Address - Street 1:4100 HERITAGE TRACE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-1306
Mailing Address - Country:US
Mailing Address - Phone:817-741-6100
Mailing Address - Fax:817-741-3686
Practice Address - Street 1:4100 HERITAGE TRACE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-1306
Practice Address - Country:US
Practice Address - Phone:817-741-6100
Practice Address - Fax:817-741-3686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX178281223P0221X
TX222411223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty