Affordable Dentures & Implants - Texas, PLLC
Dentist, General Practice in Tyler, TX. Organization (NPI-2).
NPI number1457843450
StatusActive
Last updated in NPPESNov 17, 2021
Details
- NPI
- 1457843450
- Entity type
- Organization (NPI-2)
- Legal business name
- Affordable Dentures & Implants - Texas, PLLC
- Organization subpart
- No
- Enumeration date
- Jun 5, 2018
- Certification date
- Nov 17, 2021
- Last updated
- Nov 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
8938 South BroadwaySte 480
Tyler, TX 75703
Phone 903-201-8380
Mailing address
8938 S Broadway Ave Ste 380Tyler, TX 75703-5735
Phone 903-201-8380
Authorized official
Haley Wooster
Enrollment Specialist
7127338551
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