Provider Demographics
NPI:1538405196
Name:ALINE SPEER, DDS, MS, PLLC
Entity type:Organization
Organization Name:ALINE SPEER, DDS, MS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALINE
Authorized Official - Middle Name:GURJAO
Authorized Official - Last Name:SPEER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:214-517-9452
Mailing Address - Street 1:4514 COLE AVE STE 902
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4172
Mailing Address - Country:US
Mailing Address - Phone:214-559-4670
Mailing Address - Fax:214-521-6486
Practice Address - Street 1:4514 COLE AVE STE 902
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4172
Practice Address - Country:US
Practice Address - Phone:214-559-4670
Practice Address - Fax:214-521-6486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28374261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental