Provider Demographics
NPI:1134557697
Name:CHADWICK M LINDT, D.D.S., P.C.
Entity type:Organization
Organization Name:CHADWICK M LINDT, D.D.S., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHADWICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LINDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-627-2778
Mailing Address - Street 1:1101 W EAGLE DR
Mailing Address - Street 2:STE. A
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3721
Mailing Address - Country:US
Mailing Address - Phone:940-627-2778
Mailing Address - Fax:
Practice Address - Street 1:1101 W EAGLE DR
Practice Address - Street 2:STE. A
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3721
Practice Address - Country:US
Practice Address - Phone:940-627-2778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty