NPI age
18 years
Enumerated 2008-04-22
Across 9237 active dentist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 88D356 | BCBS |
| 01 (TX) | B-18974-1 | CHIP |
| 01 (TN) | 983207 | UNITED CONCORDIA |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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