Full Name | |
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Speciality | Dentist - General Practice |
Location | 104 W 3rd St, Quanah, Texas |
Authorized Official Name and Position | Matthew C Kolar (OWNER) |
Authorized Official Contact | 9406635353 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 486 Quanah TX 79252-0486 Ph: (940) 663-5353 | 104 W 3rd St Quanah TX 79252-4034 Ph: (940) 663-5353 |
NPI Number | 1992053979 |
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Provider Enumeration Date | 08/22/2012 |
Last Update Date | 08/22/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992053979 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 27277 (Texas) | Primary |