| Pediatric Dentistry Of Tyler, Pllc | |
|
3607 Old Jacksonville Rd Tyler TX 75701-8512 | |
| (903) 595-5476 | |
| Not Available |
| Full Name | Pediatric Dentistry Of Tyler, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 3607 Old Jacksonville Rd, Tyler, Texas |
| Authorized Official Name and Position | John D Carter (PRESIDENT) |
| Authorized Official Contact | 9035955476 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dentistry Of Tyler, Pllc 3607 Old Jacksonville Rd Tyler TX 75701-8512 Ph: (903) 595-5476 | Pediatric Dentistry Of Tyler, Pllc 3607 Old Jacksonville Rd Tyler TX 75701-8512 Ph: (903) 595-5476 |
| NPI Number | 1083842629 |
|---|---|
| Provider Enumeration Date | 06/22/2009 |
| Last Update Date | 06/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083842629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
Kim Fretty Orthodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6989 Highlands Ln, Tyler, TX 75703 Phone: 903-561-7873 | |