Provider Demographics
NPI:1952314452
Name:DAHL, EUGENE WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:WILLIAM
Last Name:DAHL
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 1:7777 FOREST LANE
Mailing Address - Street 2:SUITE A 309
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2507
Mailing Address - Country:US
Mailing Address - Phone:972-566-6300
Mailing Address - Fax:972-542-6858
Practice Address - Street 1:7777 FOREST LANE
Practice Address - Street 2:SUITE A 309
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2507
Practice Address - Country:US
Practice Address - Phone:972-566-6300
Practice Address - Fax:972-542-6858
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142981223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics