Provider Demographics
NPI:1043407513
Name:TREGRE & ASSOCIATES DDS
Entity type:Organization
Organization Name:TREGRE & ASSOCIATES DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER SR
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TREGRE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-479-2841
Mailing Address - Street 1:4518 CENTER STREET
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-6351
Mailing Address - Country:US
Mailing Address - Phone:281-479-2841
Mailing Address - Fax:281-479-6238
Practice Address - Street 1:4518 CENTER STREET
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-6351
Practice Address - Country:US
Practice Address - Phone:281-479-2841
Practice Address - Fax:281-479-6238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16022122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005457069OtherAETNA
724554OtherUNITED CONCORDIA