| Hometown Dental | |
|
1464 S Circle St Sealy TX 77474-3914 | |
| (979) 627-7779 | |
| (979) 627-7203 |
| Full Name | Hometown Dental |
|---|---|
| Speciality | Dentist |
| Location | 1464 S Circle St, Sealy, Texas |
| Authorized Official Name and Position | Dolores C Mora (OWNER) |
| Authorized Official Contact | 2813918882 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hometown Dental 1464 S Circle St Sealy TX 77474-3914 Ph: (979) 627-7779 | Hometown Dental 1464 S Circle St Sealy TX 77474-3914 Ph: (979) 627-7779 |
| NPI Number | 1588994123 |
|---|---|
| Provider Enumeration Date | 01/04/2010 |
| Last Update Date | 04/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588994123 | NPI | - | NPPES |
| 1801842281 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20024 (Texas) | Primary |
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