| Kim Fretty Orthodontics Pllc | |
|
6989 Highlands Ln Tyler TX 75703-0639 | |
| (903) 561-7873 | |
| Not Available |
| Full Name | Kim Fretty Orthodontics Pllc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 6989 Highlands Ln, Tyler, Texas |
| Authorized Official Name and Position | Corneil Kimberly Fretty (PRESIDENT) |
| Authorized Official Contact | 9039182519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Fretty Orthodontics Pllc 6989 Highlands Ln Tyler TX 75703-0639 Ph: (903) 561-7873 | Kim Fretty Orthodontics Pllc 6989 Highlands Ln Tyler TX 75703-0639 Ph: (903) 561-7873 |
| NPI Number | 1083264378 |
|---|---|
| Provider Enumeration Date | 09/18/2019 |
| Last Update Date | 09/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083264378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
Pediatric Dentistry Of Tyler, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3607 Old Jacksonville Rd, Tyler, TX 75701 Phone: 903-595-5476 | |