Provider Demographics
NPI:1871683680
Name:CANTRELL, CALEEN DAVON (DDS)
Entity Type:Individual
Prefix:
First Name:CALEEN
Middle Name:DAVON
Last Name:CANTRELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8756 TEEL PARKWAY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:972-335-9997
Mailing Address - Fax:972-335-9297
Practice Address - Street 1:8756 TEEL PARKWAY
Practice Address - Street 2:SUITE 306
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:972-335-9997
Practice Address - Fax:972-335-9297
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX197361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry