Provider Demographics
NPI:1477572279
Name:DOERRE, DAVID LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEE
Last Name:DOERRE
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 1:115 N AVE D
Mailing Address - Street 2:
Mailing Address - City:BURKBURNETT
Mailing Address - State:TX
Mailing Address - Zip Code:76354-3510
Mailing Address - Country:US
Mailing Address - Phone:940-569-4901
Mailing Address - Fax:940-569-3999
Practice Address - Street 1:115 N AVENUE D
Practice Address - Street 2:
Practice Address - City:BURKBURNETT
Practice Address - State:TX
Practice Address - Zip Code:76354-3510
Practice Address - Country:US
Practice Address - Phone:940-569-4901
Practice Address - Fax:940-569-3999
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX126501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice