Organization
AIRLINE DRIVE FAMILY DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVERETT CHAD EVANS DDS (OWNER/DENTIST)
(940) 220-7833
Entity
Organization
Contact information
Practice address
7413 AIRLINE DR STE 200, HOUSTON, TX 77076-1038
(940) 220-7833
Mailing address
5800 N I 35 STE 205, DENTON, TX 76207-1438
(940) 220-7833
(855) 731-5147
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433415301
—
TX
Enumeration date
12/27/2021
Last updated
07/26/2022
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