NPI age
20 years
Enumerated 2005-07-18
Across 935 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1305914-04 | |
| 05 (TX) | 1305914-06 | |
| 01 (TX) | D10546 | DELTA TX CHIPS |
| 01 (TX) | 424189 | UNITED CONCORDIA |
| 01 (TX) | 742404710 | TAX ID |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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