Pediatric Dentistry Of Keller Pllc | |
1627 Keller Parkway Suite 100 Keller TX 76248 | |
(480) 207-9709 | |
Not Available |
Full Name | Pediatric Dentistry Of Keller Pllc |
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Speciality | Dentist - Pediatric Dentistry |
Location | 1627 Keller Parkway, Keller, Texas |
Authorized Official Name and Position | Jacob Johnson (MEMBER) |
Authorized Official Contact | 4802079709 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Pediatric Dentistry Of Keller Pllc 2101 Bradley Dr Keller TX 76248-6868 Ph: (480) 207-9709 | Pediatric Dentistry Of Keller Pllc 1627 Keller Parkway Suite 100 Keller TX 76248 Ph: (480) 207-9709 |
NPI Number | 1750934253 |
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Provider Enumeration Date | 07/23/2019 |
Last Update Date | 07/23/2019 |
Identifier | Type | State | Issuer |
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1750934253 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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