Individual
DR. DAVID ROKETHA MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2922B MARTIN LUTHER KING JR BLVD, DALLAS, TX 75215
(214) 425-2686
(214) 426-6813
Mailing address
2421 DAYBREAK DR, ROCKWALL, TX 75032-7261
(214) 771-0167
(214) 771-0167
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130713406
—
TX
05
—
130713409
—
TX
05
—
18037601
—
TX
01
—
G60266-01
DELTA DENTAL INSURANCE CO
—
01
—
QQ04
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/26/2006
Last updated
03/03/2008
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