NPI age
19 years
Enumerated 2007-02-06
Across 15661 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 117867 | DENTAL BENEFIT PROVIDER |
| 01 (TX) | 19158 | LICENSE # |
| 01 (TX) | B1915801 | TEXAS CHIP |
| 01 (TX) | D284806 | CIGNA INS. |
| 01 (TX) | 553022 | UNITED CONCORDIA |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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