NPI age
19 years
Enumerated 2006-07-11
Across 15661 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 21422 | DENTIST LICENSE |
| 05 (TX) | 164876801 | |
| 01 (AZ) | D008391 | DENTIST LICENSE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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