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2306 W Frank Ave Suite B Lufkin TX 75904-3599 | |
| (936) 634-2216 | |
| (936) 634-2229 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2306 W Frank Ave, Lufkin, Texas |
| Authorized Official Name and Position | Valerie B. Fajen (PRESIDENT) |
| Authorized Official Contact | 9368755422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
601 Cox Rd Lufkin TX 75904-4767 Ph: (936) 875-5422 | 2306 W Frank Ave Suite B Lufkin TX 75904-3599 Ph: (936) 634-2216 |
| NPI Number | 1366655011 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 09/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366655011 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 15126 (Texas) | Primary |
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