| Fusion Dental- Hewitt Pllc | |
|
1605 Hewitt Dr. Suite 102 Waco TX 76712 | |
| (254) 799-4867 | |
| (254) 799-4872 |
| Full Name | Fusion Dental- Hewitt Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1605 Hewitt Dr., Waco, Texas |
| Authorized Official Name and Position | Angela Jeffcoat (OFFICE MANAGER) |
| Authorized Official Contact | 2547994867 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fusion Dental- Hewitt Pllc 121 Eastgate Plz Bellmead TX 76705-2868 Ph: (254) 799-4867 | Fusion Dental- Hewitt Pllc 1605 Hewitt Dr. Suite 102 Waco TX 76712 Ph: (254) 799-4867 |
| NPI Number | 1114441755 |
|---|---|
| Provider Enumeration Date | 07/26/2017 |
| Last Update Date | 07/26/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114441755 | NPI | - | NPPES |
| 288519603 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 27552 (Texas) | Primary |
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