Provider Demographics
NPI:1932329562
Name:DFW ENDODONTIC ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:DFW ENDODONTIC ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAZEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:817-268-8340
Mailing Address - Street 1:1750 CAVENDER DR
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3546
Mailing Address - Country:US
Mailing Address - Phone:817-268-8340
Mailing Address - Fax:817-268-3835
Practice Address - Street 1:1750 CAVENDER DR
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3546
Practice Address - Country:US
Practice Address - Phone:817-268-8340
Practice Address - Fax:817-268-3835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174071223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty