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104 Spanish Oaks Trail Glen Rose TX 76043 | |
(254) 897-3143 | |
(903) 465-1134 |
Full Name | |
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Speciality | Dentist |
Location | 104 Spanish Oaks Trail, Glen Rose, Texas |
Authorized Official Name and Position | Clayton K Cook (OWNER DENTIST) |
Authorized Official Contact | 8172941090 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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104 Spanish Oaks Trail Glen Rose TX 76043 Ph: (254) 897-3143 | 104 Spanish Oaks Trail Glen Rose TX 76043 Ph: (254) 897-3143 |
NPI Number | 1942687264 |
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Provider Enumeration Date | 05/06/2015 |
Last Update Date | 09/30/2021 |
Identifier | Type | State | Issuer |
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1942687264 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 29154 (Texas) | Primary |