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5297 S. 31st Street Ste 111 Temple TX 76502 | |
| (254) 773-0055 | |
| (254) 773-0100 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5297 S. 31st Street, Temple, Texas |
| Authorized Official Name and Position | Quang T Luong (OWNER) |
| Authorized Official Contact | 2547730055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5297 S. 31st Street Ste 111 Temple TX 76502 Ph: (254) 773-0055 | 5297 S. 31st Street Ste 111 Temple TX 76502 Ph: (254) 773-0055 |
| NPI Number | 1275167488 |
|---|---|
| Provider Enumeration Date | 02/26/2020 |
| Last Update Date | 02/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275167488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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Waterford Oral Surgery Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5246 S 31st St, Temple, TX 76502 Phone: 254-773-4444 Fax: 254-773-4449 | |
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