| Eagle Mountain Pediatric Dentistry | |
|
705 W Bailey Boswell Rd Saginaw TX 76179-1020 | |
| (817) 576-1600 | |
| Not Available |
| Full Name | Eagle Mountain Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 705 W Bailey Boswell Rd, Saginaw, Texas |
| Authorized Official Name and Position | Jeremy Lustig (CEO) |
| Authorized Official Contact | 2143350862 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Mountain Pediatric Dentistry 3575 Lone Star Cir Ste 310 Fort Worth TX 76177-8908 Ph: (817) 350-6500 | Eagle Mountain Pediatric Dentistry 705 W Bailey Boswell Rd Saginaw TX 76179-1020 Ph: (817) 576-1600 |
| NPI Number | 1669080487 |
|---|---|
| Provider Enumeration Date | 07/17/2020 |
| Last Update Date | 07/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669080487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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