| Star Mountain Family Dental Pllc | |
|
11601 Pellicano Dr El Paso TX 79936-6279 | |
| (915) 594-4048 | |
| Not Available |
| Full Name | Star Mountain Family Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11601 Pellicano Dr, El Paso, Texas |
| Authorized Official Name and Position | Jacquelyn Luera (OWNER) |
| Authorized Official Contact | 9155944048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Mountain Family Dental Pllc 11601 Pellicano Dr El Paso TX 79936-6279 Ph: (915) 594-4048 | Star Mountain Family Dental Pllc 11601 Pellicano Dr El Paso TX 79936-6279 Ph: (915) 594-4048 |
| NPI Number | 1164074829 |
|---|---|
| Provider Enumeration Date | 07/12/2019 |
| Last Update Date | 06/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164074829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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