Provider Demographics
NPI:1649600966
Name:DEAN, DAVID I (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DEAN
Suffix:I
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 1:3900 AMERICAN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6191
Mailing Address - Country:US
Mailing Address - Phone:972-964-2900
Mailing Address - Fax:
Practice Address - Street 1:3900 AMERICAN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6191
Practice Address - Country:US
Practice Address - Phone:972-964-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1548871223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics