| Full Smile Periodontics, Pllc | |
|
4515 Van Winkle Dr Amarillo TX 79119-6423 | |
| (806) 699-6111 | |
| (806) 353-7077 |
| Full Name | Full Smile Periodontics, Pllc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 4515 Van Winkle Dr, Amarillo, Texas |
| Authorized Official Name and Position | William E Graves (OWNER) |
| Authorized Official Contact | 8063531055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Smile Periodontics, Pllc 5051 S Soncy Rd Amarillo TX 79119-6667 Ph: (806) 353-1055 | Full Smile Periodontics, Pllc 4515 Van Winkle Dr Amarillo TX 79119-6423 Ph: (806) 699-6111 |
| NPI Number | 1083359368 |
|---|---|
| Provider Enumeration Date | 05/02/2022 |
| Last Update Date | 06/03/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083359368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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