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1618 Canyon Creek Dr Suite 110 Temple TX 76502-3275 | |
| (254) 771-5900 | |
| (254) 771-5380 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1618 Canyon Creek Dr, Temple, Texas |
| Authorized Official Name and Position | Kinnari Prajapati (PRESIDENT) |
| Authorized Official Contact | 2547715900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7718 Buckmeadow Dr Georgetown TX 78628-3708 Ph: (512) 869-8300 | 1618 Canyon Creek Dr Suite 110 Temple TX 76502-3275 Ph: (254) 771-5900 |
| NPI Number | 1417085242 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417085242 | NPI | - | NPPES |
| 01361994 | Other | TX | UC |
| B20617 | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20617 (Texas) | Primary |
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