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6439 Old Jacksonville Hwy Tyler TX 75703-0577 | |
| (903) 592-5934 | |
| (903) 597-8822 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6439 Old Jacksonville Hwy, Tyler, Texas |
| Authorized Official Name and Position | Timothy R Smith (DENTIST OWNER) |
| Authorized Official Contact | 9035925934 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6439 Old Jacksonville Hwy Tyler TX 75703-0577 Ph: (903) 592-5934 | 6439 Old Jacksonville Hwy Tyler TX 75703-0577 Ph: (903) 592-5934 |
| NPI Number | 1811198484 |
|---|---|
| Provider Enumeration Date | 05/30/2007 |
| Last Update Date | 06/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811198484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
Kim Fretty Orthodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6989 Highlands Ln, Tyler, TX 75703 Phone: 903-561-7873 | |
Pediatric Dentistry Of Tyler, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3607 Old Jacksonville Rd, Tyler, TX 75701 Phone: 903-595-5476 | |