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602 Hickory St Ste B Abilene TX 79601-5044 | |
| (325) 676-7707 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 602 Hickory St Ste B, Abilene, Texas |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
602 Hickory St Ste B Abilene TX 79601-5044 Ph: (325) 603-4731 | 602 Hickory St Ste B Abilene TX 79601-5044 Ph: (325) 676-7707 |
| NPI Number | 1083098289 |
|---|---|
| Provider Enumeration Date | 07/17/2015 |
| Last Update Date | 12/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083098289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 23588 (Texas) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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