| Alpha First Dental Clinic P.a | |
|
724 Us Highway 259 N Ste 101 Kilgore TX 75662-6042 | |
| (903) 218-6300 | |
| (903) 212-4210 |
| Full Name | Alpha First Dental Clinic P.a |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 724 Us Highway 259 N Ste 101, Kilgore, Texas |
| Authorized Official Name and Position | Omowumi Akhuini Ihionkhan (DENTIST/DIRECTOR) |
| Authorized Official Contact | 9032429777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha First Dental Clinic P.a 724 Us Highway 259 N Ste 101 Kilgore TX 75662-6042 Ph: (903) 218-6300 | Alpha First Dental Clinic P.a 724 Us Highway 259 N Ste 101 Kilgore TX 75662-6042 Ph: (903) 218-6300 |
| NPI Number | 1225375942 |
|---|---|
| Provider Enumeration Date | 01/15/2013 |
| Last Update Date | 07/29/2020 |
| Certification Date | 07/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225375942 | NPI | - | NPPES |
| 3233496-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20172 (Texas) | Primary |
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