Provider Demographics
NPI:1902924376
Name:JOHN L. ESTES III DDS INC
Entity Type:Organization
Organization Name:JOHN L. ESTES III DDS INC
Other - Org Name:ESTES FAMILY DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:325-677-2645
Mailing Address - Street 1:1809 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-2479
Mailing Address - Country:US
Mailing Address - Phone:325-677-2645
Mailing Address - Fax:
Practice Address - Street 1:1809 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2479
Practice Address - Country:US
Practice Address - Phone:325-677-2645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10988261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental