NPI age
19 years
Enumerated 2006-11-01
Across 9237 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | D13269 | BCBS |
| 01 (TX) | B13269-01 | CHIPS |
| 05 (TX) | 1112666-01 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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