| Northeast Dental Center | |
|
9201 Dyer St Suite B El Paso TX 79924-6441 | |
| (915) 751-7070 | |
| Not Available |
| Full Name | Northeast Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9201 Dyer St, El Paso, Texas |
| Authorized Official Name and Position | Dwight L Bailey (PRESIDENT) |
| Authorized Official Contact | 9157517070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Dental Center 9201 Dyer St Suite B El Paso TX 79924-6441 Ph: (915) 751-7070 | Northeast Dental Center 9201 Dyer St Suite B El Paso TX 79924-6441 Ph: (915) 751-7070 |
| NPI Number | 1013208776 |
|---|---|
| Provider Enumeration Date | 04/28/2011 |
| Last Update Date | 04/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013208776 | NPI | - | NPPES |
| 1538314232 | Other | TX | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 24393 (Texas) | Primary |
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