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1615 Forest Trl Temple TX 76502-2715 | |
| (254) 778-6440 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1615 Forest Trl, Temple, Texas |
| Authorized Official Name and Position | Celia Hayes (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408905 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1615 Forest Trl Temple TX 76502-2715 Ph: (254) 778-6440 | 1615 Forest Trl Temple TX 76502-2715 Ph: (254) 778-6440 |
| NPI Number | 1124771142 |
|---|---|
| Provider Enumeration Date | 01/31/2022 |
| Last Update Date | 04/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124771142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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