Provider Demographics
NPI:1013324870
Name:MY DFW DENTIST
Entity Type:Organization
Organization Name:MY DFW DENTIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEZNIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-594-4888
Mailing Address - Street 1:2820 N O CONNOR RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4491
Mailing Address - Country:US
Mailing Address - Phone:972-594-4888
Mailing Address - Fax:972-594-4839
Practice Address - Street 1:2820 N O CONNOR RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4491
Practice Address - Country:US
Practice Address - Phone:972-594-4888
Practice Address - Fax:972-594-4839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty