| Polk County Dental Care | |
|
1114 N Washington Ave Livingston TX 77351-2336 | |
| (936) 327-7477 | |
| (936) 327-7479 |
| Full Name | Polk County Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1114 N Washington Ave, Livingston, Texas |
| Authorized Official Name and Position | Ralph Kenneth Jenke (PRESIDENT/OWNER) |
| Authorized Official Contact | 9363277477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Polk County Dental Care 1114 N Washington Ave Livingston TX 77351-2336 Ph: (936) 327-7477 | Polk County Dental Care 1114 N Washington Ave Livingston TX 77351-2336 Ph: (936) 327-7477 |
| NPI Number | 1174882328 |
|---|---|
| Provider Enumeration Date | 05/09/2012 |
| Last Update Date | 05/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174882328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10766 (Texas) | Primary |
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