Provider Demographics
NPI:1962510701
Name:SEZNIK, DEBRA E (DDS)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:E
Last Name:SEZNIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 SAINT ALBANS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-2317
Mailing Address - Country:US
Mailing Address - Phone:972-262-2546
Mailing Address - Fax:972-642-2495
Practice Address - Street 1:308 NW 2ND ST STE 1
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5677
Practice Address - Country:US
Practice Address - Phone:972-262-2546
Practice Address - Fax:972-642-2495
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice