Provider Demographics
NPI:1285762575
Name:DENTAL VISIONS, P.A.
Entity type:Organization
Organization Name:DENTAL VISIONS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-295-7116
Mailing Address - Street 1:312 E RENFRO ST
Mailing Address - Street 2:#204
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-3947
Mailing Address - Country:US
Mailing Address - Phone:817-295-7116
Mailing Address - Fax:817-295-1404
Practice Address - Street 1:312 E RENFRO ST
Practice Address - Street 2:#204
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3947
Practice Address - Country:US
Practice Address - Phone:817-295-7116
Practice Address - Fax:817-295-1404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty