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1901 E Main St League City TX 77573-4242 | |
(281) 332-6323 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1901 E Main St, League City, Texas |
Authorized Official Name and Position | Kimberly Carroll (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8323858875 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1901 E Main St League City TX 77573-4242 Ph: (281) 332-6323 | 1901 E Main St League City TX 77573-4242 Ph: (281) 332-6323 |
NPI Number | 1346782620 |
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Provider Enumeration Date | 11/17/2016 |
Last Update Date | 11/17/2016 |
Identifier | Type | State | Issuer |
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1346782620 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 14289 (Texas) | Primary |
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