| Fredrick J. Platt, Dds, Pllc | |
|
2020 Lindbergh Dr Tyler TX 75703-1714 | |
| (903) 592-7111 | |
| (903) 535-9210 |
| Full Name | Fredrick J. Platt, Dds, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2020 Lindbergh Dr, Tyler, Texas |
| Authorized Official Name and Position | Fredrick Joseph Platt (OWNER) |
| Authorized Official Contact | 9035927111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fredrick J. Platt, Dds, Pllc 2020 Lindbergh St Tyler TX 75703-1714 Ph: (903) 592-7111 | Fredrick J. Platt, Dds, Pllc 2020 Lindbergh Dr Tyler TX 75703-1714 Ph: (903) 592-7111 |
| NPI Number | 1417211525 |
|---|---|
| Provider Enumeration Date | 07/03/2012 |
| Last Update Date | 06/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417211525 | NPI | - | NPPES |
| 3153009-02 | Medicaid | TX | |
| 3153009-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 25670 (Texas) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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