| Grill Repair, Pa | |
|
1012 E Ennis Ave Ennis TX 75119-4345 | |
| (817) 897-6006 | |
| Not Available |
| Full Name | Grill Repair, Pa |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1012 E Ennis Ave, Ennis, Texas |
| Authorized Official Name and Position | Bryan Elvebak (OWNER) |
| Authorized Official Contact | 8178976006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grill Repair, Pa 1012 E Ennis Ave Ennis TX 75119-4345 Ph: (817) 897-6006 | Grill Repair, Pa 1012 E Ennis Ave Ennis TX 75119-4345 Ph: (817) 897-6006 |
| NPI Number | 1487952164 |
|---|---|
| Provider Enumeration Date | 03/04/2011 |
| Last Update Date | 03/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487952164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 20522 (Texas) | Primary |
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Larry W. Treadaway, D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 504 S Clay St, Ennis, TX 75119 Phone: 972-875-6081 Fax: 972-875-5043 | |
Stephen C. Durbin, Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 W Ennis Ave, Ennis, TX 75119 Phone: 972-875-9031 Fax: 972-878-9032 | |
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