| Larry W. Treadaway, D.d.s., Inc. | |
|
504 S Clay St Ennis TX 75119-4551 | |
| (972) 875-6081 | |
| (972) 875-5043 |
| Full Name | Larry W. Treadaway, D.d.s., Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 504 S Clay St, Ennis, Texas |
| Authorized Official Name and Position | Larry W Treadaway (OWNER) |
| Authorized Official Contact | 9728756081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Larry W. Treadaway, D.d.s., Inc. 504 S Clay St Ennis TX 75119-4551 Ph: (972) 875-6081 | Larry W. Treadaway, D.d.s., Inc. 504 S Clay St Ennis TX 75119-4551 Ph: (972) 875-6081 |
| NPI Number | 1225196264 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225196264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12249 (Texas) | Primary |
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