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Organization
LARRY W. TREADAWAY, D.D.S., INC.
Active
Organization
LARRY W. TREADAWAY, D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY W TREADAWAY D.D.S. (OWNER)
(972) 875-6081
Entity
Organization
Contact information
Practice address
504 S CLAY ST, ENNIS, TX 75119-4551
(972) 875-6081
(972) 875-5043
Mailing address
504 S CLAY ST, ENNIS, TX 75119-4551
(972) 875-6081
(972) 875-5043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12249
TX
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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