Provider Demographics
NPI:1881864056
Name:DAVID M CALDWELL DDS PC
Entity Type:Organization
Organization Name:DAVID M CALDWELL DDS PC
Other - Org Name:DOWNTOWN DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:409-835-7133
Mailing Address - Street 1:715 ORLEANS ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701
Mailing Address - Country:US
Mailing Address - Phone:409-835-7133
Mailing Address - Fax:409-835-7180
Practice Address - Street 1:715 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701
Practice Address - Country:US
Practice Address - Phone:409-835-7133
Practice Address - Fax:409-835-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX128031223G0001X
TX229171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty