Provider Demographics
NPI:1801815295
Name:SWEET, DAVID GREGORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GREGORY
Last Name:SWEET
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 1:1605 FOREST TRL
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2715
Mailing Address - Country:US
Mailing Address - Phone:254-778-7581
Mailing Address - Fax:254-598-2298
Practice Address - Street 1:1605 FOREST TRL
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-2715
Practice Address - Country:US
Practice Address - Phone:254-778-3751
Practice Address - Fax:254-771-0235
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX149961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX741767146OtherTAX IDENTIFICATION NUMBER