Provider Demographics
NPI:1447370374
Name:PRICE, JANET EILEEN (DDS)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:EILEEN
Last Name:PRICE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:EILEEN
Other - Last Name:STUKALIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5925 FOREST LN STE 318
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2776
Mailing Address - Country:US
Mailing Address - Phone:972-490-4881
Mailing Address - Fax:972-490-1270
Practice Address - Street 1:5925 FOREST LN STE 318
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2776
Practice Address - Country:US
Practice Address - Phone:972-490-4881
Practice Address - Fax:972-490-1270
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice