Provider Demographics
NPI:1639294804
Name:DICKEY, STEPHEN D (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:DICKEY
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 1:1333 W MCDERMOTT DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3090
Mailing Address - Country:US
Mailing Address - Phone:972-747-7777
Mailing Address - Fax:972-747-8337
Practice Address - Street 1:1333 W MCDERMOTT DR
Practice Address - Street 2:SUITE 140
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3090
Practice Address - Country:US
Practice Address - Phone:972-747-7777
Practice Address - Fax:972-747-8337
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice