Sun City Dental, Pllc | |
11240 Montwood Dr Suite J El Paso TX 79936-4249 | |
(915) 201-2539 | |
(915) 613-5082 |
Full Name | Sun City Dental, Pllc |
---|---|
Speciality | Dentist - General Practice |
Location | 11240 Montwood Dr, El Paso, Texas |
Authorized Official Name and Position | Iven Gonzalez (DIRECTOR/DENTIST) |
Authorized Official Contact | 9152012539 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sun City Dental, Pllc 11240 Montwood Dr Suite J El Paso TX 79936-4249 Ph: (915) 201-2539 | Sun City Dental, Pllc 11240 Montwood Dr Suite J El Paso TX 79936-4249 Ph: (915) 201-2539 |
NPI Number | 1770901001 |
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Provider Enumeration Date | 04/03/2014 |
Last Update Date | 05/26/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770901001 | NPI | - | NPPES |
32048136579 | Other | TX | TEXAS TAX PAYER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 25489 (Texas) | Primary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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