| Lone Star Family Dental | |
|
2306 Airline Rd Corpus Christi TX 78414-2941 | |
| (361) 299-5633 | |
| Not Available |
| Full Name | Lone Star Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 2306 Airline Rd, Corpus Christi, Texas |
| Authorized Official Name and Position | Thomas Nguyen (OWNER) |
| Authorized Official Contact | 2069483741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Star Family Dental 3114 Paris Dr Corpus Christi TX 78414-3568 Ph: () - | Lone Star Family Dental 2306 Airline Rd Corpus Christi TX 78414-2941 Ph: (361) 299-5633 |
| NPI Number | 1881115491 |
|---|---|
| Provider Enumeration Date | 07/05/2017 |
| Last Update Date | 07/05/2017 |
| Medicare PECOS PAC ID | 9537430236 |
|---|---|
| Medicare Enrollment ID | O20170728002159 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881115491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 25414 (Texas) | Primary |
| Provider Name | Thomas Nguyen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1558420455 PECOS PAC ID: 8123325115 Enrollment ID: I20170728002297 |
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