| Enchanted Forest Pediatric Dentistry | |
|
110 Vision Park Blvd. Suite 100 Shenandoah TX 77384-8044 | |
| (936) 231-8705 | |
| (936) 447-9681 |
| Full Name | Enchanted Forest Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 110 Vision Park Blvd., Shenandoah, Texas |
| Authorized Official Name and Position | Luz M Rojas (PRESIDENT) |
| Authorized Official Contact | 9362318705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enchanted Forest Pediatric Dentistry 110 Vision Park Blvd. Suite 100 Shenandoah TX 77384-8044 Ph: (936) 231-8705 | Enchanted Forest Pediatric Dentistry 110 Vision Park Blvd. Suite 100 Shenandoah TX 77384-8044 Ph: (936) 231-8705 |
| NPI Number | 1104263508 |
|---|---|
| Provider Enumeration Date | 05/27/2013 |
| Last Update Date | 10/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104263508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 21458 (Texas) | Primary |
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