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1400 N Highway 77 Ste 300 Waxahachie TX 75165-7847 | |
(469) 712-2960 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 1400 N Highway 77 Ste 300, Waxahachie, Texas |
Authorized Official Name and Position | Diana Do-yabut (OWNER) |
Authorized Official Contact | 4697122960 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 920050 Dallas TX 75392-0050 Ph: () - | 1400 N Highway 77 Ste 300 Waxahachie TX 75165-7847 Ph: (469) 712-2960 |
NPI Number | 1679118996 |
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Provider Enumeration Date | 11/11/2019 |
Last Update Date | 02/08/2022 |
Identifier | Type | State | Issuer |
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1679118996 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
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