|
| |
|
926 N Glenwood Blvd 926 N Glenwood Blvd Tyler TX 75702-5055 | |
| (903) 533-1111 | |
| (903) 533-1105 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 926 N Glenwood Blvd, Tyler, Texas |
| Authorized Official Name and Position | Aimee Lee Massey (OWNER/DENTIST) |
| Authorized Official Contact | 9035331111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
926 N Glenwood Blvd 926 N Glenwood Blvd Tyler TX 75702 Ph: (903) 533-1111 | 926 N Glenwood Blvd 926 N Glenwood Blvd Tyler TX 75702-5055 Ph: (903) 533-1111 |
| NPI Number | 1093115776 |
|---|---|
| Provider Enumeration Date | 08/29/2014 |
| Last Update Date | 08/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093115776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 20107 (Texas) | Primary |
Kim Fretty Orthodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6989 Highlands Ln, Tyler, TX 75703 Phone: 903-561-7873 | |
Pediatric Dentistry Of Tyler, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3607 Old Jacksonville Rd, Tyler, TX 75701 Phone: 903-595-5476 | |