Provider Demographics
NPI:1245251362
Name:PREECE, G. STAN (DDS)
Entity type:Individual
Prefix:
First Name:G.
Middle Name:STAN
Last Name:PREECE
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 1:4100 HERITAGE TRACE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-1306
Mailing Address - Country:US
Mailing Address - Phone:817-741-6100
Mailing Address - Fax:817-741-3686
Practice Address - Street 1:4100 HERITAGE TRACE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-1306
Practice Address - Country:US
Practice Address - Phone:817-741-6100
Practice Address - Fax:817-741-3686
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX178281223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry