Provider Demographics
NPI:1770737041
Name:CANFIELD, DAVID WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:CANFIELD
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 1:14742 FM 981
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:75424-3551
Mailing Address - Country:US
Mailing Address - Phone:214-384-0796
Mailing Address - Fax:
Practice Address - Street 1:14742 FM 981
Practice Address - Street 2:
Practice Address - City:BLUE RIDGE
Practice Address - State:TX
Practice Address - Zip Code:75424-3551
Practice Address - Country:US
Practice Address - Phone:214-384-0796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15229122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice