| |
7500 N Mesa St Ste 304 El Paso TX 79912-3512 | |
(915) 231-9983 | |
(915) 231-9966 |
Full Name | |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 7500 N Mesa St Ste 304, El Paso, Texas |
Authorized Official Name and Position | John G Vondrak (OWNER) |
Authorized Official Contact | 9152319983 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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7500 N Mesa St Ste 304 El Paso TX 79912-3512 Ph: (915) 231-9983 | 7500 N Mesa St Ste 304 El Paso TX 79912-3512 Ph: (915) 231-9983 |
NPI Number | 1255602868 |
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Provider Enumeration Date | 01/13/2012 |
Last Update Date | 01/13/2012 |
Identifier | Type | State | Issuer |
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1255602868 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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