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2210 N Frazier St Conroe TX 77303-1780 | |
| (936) 539-3636 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2210 N Frazier St, Conroe, Texas |
| Authorized Official Name and Position | Timothy Gardner (OWNER) |
| Authorized Official Contact | 9365393636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2210 N Frazier St Conroe TX 77303-1780 Ph: (936) 539-3636 | 2210 N Frazier St Conroe TX 77303-1780 Ph: (936) 539-3636 |
| NPI Number | 1114443207 |
|---|---|
| Provider Enumeration Date | 08/21/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114443207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 16499 (Texas) | Primary |
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