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409 E Crockett St Luling TX 78648-2601 | |
(830) 875-3521 | |
(830) 875-2212 |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 409 E Crockett St, Luling, Texas |
Authorized Official Name and Position | Tammera Torres (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 5128094162 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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409 E Crockett St Luling TX 78648-2601 Ph: (830) 875-3521 | 409 E Crockett St Luling TX 78648-2601 Ph: (830) 875-3521 |
NPI Number | 1992114185 |
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Provider Enumeration Date | 08/13/2014 |
Last Update Date | 08/13/2014 |
Identifier | Type | State | Issuer |
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1992114185 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |