Provider Demographics
NPI:1952380826
Name:NAIL, GEORGE ALLEN (MD DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALLEN
Last Name:NAIL
Suffix:
Gender:M
Credentials:MD DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 GOLDEN TRAIL CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4649
Mailing Address - Country:US
Mailing Address - Phone:972-395-7630
Mailing Address - Fax:972-395-7625
Practice Address - Street 1:1813 GOLDEN TRAIL CT
Practice Address - Street 2:SUITE 100
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4649
Practice Address - Country:US
Practice Address - Phone:972-395-7630
Practice Address - Fax:972-395-7625
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX163751223S0112X
TXJ66141223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-2653490Medicare UPIN