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3010 H G Mosley Pkwy Longview TX 75605-2948 | |
(903) 759-7196 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 3010 H G Mosley Pkwy, Longview, Texas |
Authorized Official Name and Position | Marie Kuhl (CREDENTIALING MANAGER) |
Authorized Official Contact | 2175405100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3010 H G Mosley Pkwy Longview TX 75605-2948 Ph: (903) 759-7196 | 3010 H G Mosley Pkwy Longview TX 75605-2948 Ph: (903) 759-7196 |
NPI Number | 1881930196 |
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Provider Enumeration Date | 12/14/2012 |
Last Update Date | 02/12/2019 |
Identifier | Type | State | Issuer |
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1881930196 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
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