| Kerrville Pediatric Dentistry | |
|
715 Hill Country Dr Ste 5 Kerrville TX 78028-5965 | |
| (830) 255-4197 | |
| Not Available |
| Full Name | Kerrville Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 715 Hill Country Dr Ste 5, Kerrville, Texas |
| Authorized Official Name and Position | Rex Elwyn Wildey (OWNER) |
| Authorized Official Contact | 8302554197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kerrville Pediatric Dentistry 715 Hill Country Dr Ste 5 Kerrville TX 78028-5965 Ph: (830) 255-4197 | Kerrville Pediatric Dentistry 715 Hill Country Dr Ste 5 Kerrville TX 78028-5965 Ph: (830) 255-4197 |
| NPI Number | 1225409139 |
|---|---|
| Provider Enumeration Date | 10/19/2015 |
| Last Update Date | 03/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225409139 | NPI | - | NPPES |
| 211746707 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 25425 (Texas) | Primary |
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