Provider Demographics
NPI:1245349307
Name:DICKEY & WAKEFIELD DENTAL
Entity type:Organization
Organization Name:DICKEY & WAKEFIELD DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DON
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-747-7777
Mailing Address - Street 1:1333 MCDERMOTT
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013
Mailing Address - Country:US
Mailing Address - Phone:972-747-7777
Mailing Address - Fax:972-747-8337
Practice Address - Street 1:1333 MCDERMOTT
Practice Address - Street 2:SUITE 140
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:972-747-7777
Practice Address - Fax:972-747-7777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205031223G0001X
TX207381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty