| Saint Apollonia Medicaid Dental Clinic Of Texas, Pa | |
|
1108 N Mechanic St El Campo TX 77437-3030 | |
| (979) 541-5400 | |
| (979) 541-5462 |
| Full Name | Saint Apollonia Medicaid Dental Clinic Of Texas, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1108 N Mechanic St, El Campo, Texas |
| Authorized Official Name and Position | Ross Wyatt Anderson (PRESIDENT) |
| Authorized Official Contact | 9795415400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Saint Apollonia Medicaid Dental Clinic Of Texas, Pa 1108 N Mechanic St El Campo TX 77437-3030 Ph: (979) 541-5400 | Saint Apollonia Medicaid Dental Clinic Of Texas, Pa 1108 N Mechanic St El Campo TX 77437-3030 Ph: (979) 541-5400 |
| NPI Number | 1447427422 |
|---|---|
| Provider Enumeration Date | 05/09/2008 |
| Last Update Date | 05/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447427422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20250 (Texas) | Primary |
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