Affordable Dentures & Implants - Texas, PLLC
Dentist, General Practice in Georgetown, TX. Organization (NPI-2).
NPI number1750616637
StatusActive
Last updated in NPPESNov 17, 2021
Details
- NPI
- 1750616637
- Entity type
- Organization (NPI-2)
- Legal business name
- Affordable Dentures & Implants - Texas, PLLC
- Organization subpart
- No
- Enumeration date
- Oct 9, 2009
- Certification date
- Nov 17, 2021
- Last updated
- Nov 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 122300000X | Dentist | 0021124 | TX |
Practice location
1103 Rivery BlvdSte 300
Georgetown, TX 78628-3034
Phone 918-473-0285
Mailing address
1103 Rivery BlvdSte 300
Georgetown, TX 78628-3034
Authorized official
Haley Wooster
Enrollment Specialist
7127338551
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