| Hollywood Dental Center | |
|
1703 Tulane Dr Lufkin TX 75901-5607 | |
| (936) 632-4477 | |
| (936) 639-5906 |
| Full Name | Hollywood Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1703 Tulane Dr, Lufkin, Texas |
| Authorized Official Name and Position | Ralph W. Rose (SOLE MEMBER) |
| Authorized Official Contact | 9366324477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hollywood Dental Center 1703 Tulane Dr Lufkin TX 75901-5607 Ph: (936) 632-4477 | Hollywood Dental Center 1703 Tulane Dr Lufkin TX 75901-5607 Ph: (936) 632-4477 |
| NPI Number | 1710488838 |
|---|---|
| Provider Enumeration Date | 02/23/2018 |
| Last Update Date | 02/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710488838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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