NPI age
18 years
Enumerated 2007-09-10
Across 1850 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | D07589 | BLUE CROSS BLUE SHIELD |
| 01 | 803444 | UNITED CONCORDIA |
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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