| Texas Dental Implant Center | |
|
1237 County Road 197 Jonesboro TX 76538-1207 | |
| (910) 922-9644 | |
| Not Available |
| Full Name | Texas Dental Implant Center |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1237 County Road 197, Jonesboro, Texas |
| Authorized Official Name and Position | Jesse Lynn Deitz (PRACTICE DIRECTOR) |
| Authorized Official Contact | 2543008804 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Dental Implant Center 1237 County Road 197 Jonesboro TX 76538-1207 Ph: () - | Texas Dental Implant Center 1237 County Road 197 Jonesboro TX 76538-1207 Ph: (910) 922-9644 |
| NPI Number | 1780012203 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 10/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780012203 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Heritage Oral And Facial Surgery, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1237 County Road 197, Jonesboro, TX 76538 Phone: 254-300-8804 Fax: 254-350-2868 |