Provider Demographics
NPI:1851529283
Name:AUBREY FAMILY DENTAL
Entity Type:Organization
Organization Name:AUBREY FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:LUDLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-886-6900
Mailing Address - Street 1:5099 S. HWY 377
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227
Mailing Address - Country:US
Mailing Address - Phone:214-886-6900
Mailing Address - Fax:972-924-2459
Practice Address - Street 1:701 W WHITE ST STE 2
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409-4102
Practice Address - Country:US
Practice Address - Phone:972-924-2452
Practice Address - Fax:972-924-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21693122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty