Gary M Easley, DDS

Individual provider Active NPI General Practice Dentistry · Comanche, TX

NPI 1629286182 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1629286182
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
11309 (TX)
Practice address
203 Valley Forge St
Comanche, TX 76442
Phone
(325) 356-5263
Fax
(325) 356-2875
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
11309TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan L Seegmiller, DDS, PLLC Past Accepting new patients
Gary M Easley, DDS Inc General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11309 TX Yes

Addresses

Primary practice location

203 Valley Forge St
Comanche, TX 76442

Mailing address

PO Box 705
Comanche, TX 76442-0705
Phone (325) 356-5263

Other providers in Comanche, TX

All providers in Comanche, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.