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1520 Rice Road Suite 100 Tyler TX 75703-3224 | |
| (903) 597-2201 | |
| (903) 597-2282 |
| Full Name | |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 1520 Rice Road, Tyler, Texas |
| Authorized Official Name and Position | Travis L Kendall (OWNER/DENTIST) |
| Authorized Official Contact | 9035972201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1520 Rice Road Suite 100 Tyler TX 75703-3224 Ph: (903) 597-2201 | 1520 Rice Road Suite 100 Tyler TX 75703-3224 Ph: (903) 597-2201 |
| NPI Number | 1073177531 |
|---|---|
| Provider Enumeration Date | 04/30/2019 |
| Last Update Date | 05/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073177531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | (* (Not Available)) | Primary |
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