NPI age
20 years
Enumerated 2005-07-28
Across 1797 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1209090 | |
| 01 (TX) | 88D756 | BLUE CROSS |
Solo or small practice. No other active providers share this practice address in NPPES.
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