George Thomas Wickersham
Pediatric Dentist
2260 Cross Timberes Rd Ste A
Flower Mound
, Texas 75028
George Thomas Wickersham
Pediatric Dentist
2260 Cross Timberes Rd Ste A
Flower Mound
, Texas 75028
(972) 539-0165
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- George Thomas Wickersham
- 2260 Cross Timberes Rd Ste A
- Flower Mound, TX
- Zip : 75028
- Fax : (972) 539-0165
- Phone : (972) 874-2800
Second Address
- George Thomas Wickersham
- 2260 Cross Timberes Rd Ste A
- Flower Mound, TX
- Zip : 75028
- Fax : (972) 539-0165
- Phone : (972) 874-2800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | 17875 | TX |
National Provider Identifier
| NPI | 1083770465 |
|---|---|
| Provider Name | George Thomas Wickersham |
| First Address | Flower Mound, TX 75028 |
| Second Address | Flower Mound, TX 75028 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/12/2006 |
| Last Update Date | 03/10/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.