Provider Demographics
NPI:1558559609
Name:REMMERS, TODD W (DMD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:W
Last Name:REMMERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E SOUTHLAKE BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:76092
Mailing Address - Country:US
Mailing Address - Phone:817-488-3636
Mailing Address - Fax:817-421-2372
Practice Address - Street 1:1100 E SOUTHLAKE BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6357
Practice Address - Country:US
Practice Address - Phone:817-488-3636
Practice Address - Fax:817-421-2372
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000090691223E0200X
TX226841223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics