| Pine Creek Dental, Pllc | |
|
7925 S Broadway Ave Ste 300 Tyler TX 75703-5227 | |
| (903) 561-2232 | |
| Not Available |
| Full Name | Pine Creek Dental, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7925 S Broadway Ave Ste 300, Tyler, Texas |
| Authorized Official Name and Position | Christopher Tutt (DENTIST) |
| Authorized Official Contact | 9035612232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Creek Dental, Pllc 7925 S Broadway Ave Ste 300 Tyler TX 75703-5227 Ph: (903) 561-2232 | Pine Creek Dental, Pllc 7925 S Broadway Ave Ste 300 Tyler TX 75703-5227 Ph: (903) 561-2232 |
| NPI Number | 1639549454 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 01/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639549454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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