| Granbury Dental Center- Pecan Plantation | |
|
9205 Plantation Blvd Ste 105 Granbury TX 76049-4109 | |
| (817) 579-1114 | |
| (817) 573-9090 |
| Full Name | Granbury Dental Center- Pecan Plantation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9205 Plantation Blvd Ste 105, Granbury, Texas |
| Authorized Official Name and Position | Kelli Walker (INSURANCE/CREDENTIALING) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granbury Dental Center- Pecan Plantation 9205 Plantation Blvd Ste 105 Granbury TX 76049-4109 Ph: (817) 579-1114 | Granbury Dental Center- Pecan Plantation 9205 Plantation Blvd Ste 105 Granbury TX 76049-4109 Ph: (817) 579-1114 |
| NPI Number | 1215246665 |
|---|---|
| Provider Enumeration Date | 10/04/2010 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215246665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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