NPI age
19 years
Enumerated 2007-04-10
Across 15661 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | B21104-01 | TEXAS CHIPS NUMBER |
| 01 (TX) | 1750024 | UNITED CONCORDIA ID |
| 05 (TX) | 173130901 | |
| 01 (TX) | 470955683 | DELTA DENTAL NUMBER |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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