Sunshine Family Dentistry | |
1389 W Us Highway 77 Suite E San Benito TX 78586-4161 | |
(956) 399-9929 | |
(956) 399-4855 |
Full Name | Sunshine Family Dentistry |
---|---|
Speciality | Dentist |
Location | 1389 W Us Highway 77, San Benito, Texas |
Authorized Official Name and Position | Bernardino Octavio Elizondo (OWNER/ PRESIDENT) |
Authorized Official Contact | 9563999929 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sunshine Family Dentistry 1389 W Us Highway 77 Suite E San Benito TX 78586-4161 Ph: (956) 399-9929 | Sunshine Family Dentistry 1389 W Us Highway 77 Suite E San Benito TX 78586-4161 Ph: (956) 399-9929 |
NPI Number | 1851404420 |
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Provider Enumeration Date | 08/16/2006 |
Last Update Date | 04/23/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851404420 | NPI | - | NPPES |
G60092-01 | Other | TX | TEXAS CHIP |
155609401 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 19338 (Texas) | Primary |
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