| Agave Dental | |
|
119 Business Park Drive Suite 200 Kenedy TX 78119 | |
| (830) 393-8333 | |
| Not Available |
| Full Name | Agave Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 119 Business Park Drive, Kenedy, Texas |
| Authorized Official Name and Position | Sumeet Singh Malhotra (OWNER) |
| Authorized Official Contact | 6174120792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agave Dental 2006 10th St Floresville TX 78114-2770 Ph: (830) 393-8333 | Agave Dental 119 Business Park Drive Suite 200 Kenedy TX 78119 Ph: (830) 393-8333 |
| NPI Number | 1548667355 |
|---|---|
| Provider Enumeration Date | 11/21/2014 |
| Last Update Date | 12/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548667355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 26104 (Texas) | Primary |
| 261QD0000X | Clinic/center - Dental | 26104 (Texas) | Secondary |
Kenedy Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Business Park Blvd Ste 600, Kenedy, TX 78119 Phone: 830-299-3848 Fax: 830-299-3859 | |
Dr. Wade Phelps Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 W Liveoak St, Kenedy, TX 78119 Phone: 830-583-9891 |