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3310 S Southwest Loop 323 Tyler TX 75701-9236 | |
| (903) 593-3333 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3310 S Southwest Loop 323, Tyler, Texas |
| Authorized Official Name and Position | Sachin Kocharekar (PRESIDENT/DENTIST) |
| Authorized Official Contact | 5752688648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3310 S Southwest Loop 323 Tyler TX 75701-9236 Ph: (903) 593-3333 | 3310 S Southwest Loop 323 Tyler TX 75701-9236 Ph: (903) 593-3333 |
| NPI Number | 1033628714 |
|---|---|
| Provider Enumeration Date | 09/25/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033628714 | NPI | - | NPPES |
| 3506636-04 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 32777 (Texas) | Primary |
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