Provider Demographics
NPI:1124330782
Name:PECCORA, DWIGHT DANIEL (DDS)
Entity type:Individual
Prefix:DR
First Name:DWIGHT
Middle Name:DANIEL
Last Name:PECCORA
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 1:5819 HIGHWAY 6 STE 230
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4070
Mailing Address - Country:US
Mailing Address - Phone:281-499-3541
Mailing Address - Fax:
Practice Address - Street 1:5819 HIGHWAY 6 STE 230
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4070
Practice Address - Country:US
Practice Address - Phone:281-499-3541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-11
Last Update Date:2010-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0025645122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist