Basic Information
Provider Information
NPI: 1588754436
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOOLEY
FirstName: JAMES
MiddleName: SCOTT
NamePrefix: DR.
NameSuffix:  
Credential: D.D.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2645 ARAPAHO RD STE 113
Address2:  
City: GARLAND
State: TX
PostalCode: 750447943
CountryCode: US
TelephoneNumber: 9724958100
FaxNumber:  
Practice Location
Address1: 8608 PRESTON RD
Address2:  
City: PLANO
State: TX
PostalCode: 750243316
CountryCode: US
TelephoneNumber: 2146196329
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/13/2006
LastUpdateDate: 07/26/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X22751TXY Dental ProvidersDentist 

No ID Information.


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