| Boon Dental Alliance P.a. | |
|
713 N. Main Fort Stockton TX 79735 | |
| (432) 336-6466 | |
| (432) 336-8248 |
| Full Name | Boon Dental Alliance P.a. |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 713 N. Main, Fort Stockton, Texas |
| Authorized Official Name and Position | Prasith R Thammasithiboon (OWNER) |
| Authorized Official Contact | 4697338183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boon Dental Alliance P.a. 713 N. Main Fort Stockton TX 79735 Ph: (432) 336-6466 | Boon Dental Alliance P.a. 713 N. Main Fort Stockton TX 79735 Ph: (432) 336-6466 |
| NPI Number | 1306065693 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 03/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306065693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | (* (Not Available)) | Primary |
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