NPI age
20 years
Enumerated 2006-01-12
Across 935 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 | 731009960006 | TRICARE |
| 01 | 838355 | UNITED CONCORDIA |
| 01 | 80W703 | BCBS |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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