| Athens Dental Works | |
|
6300 State Highway 19 S Athens TX 75751-8966 | |
| (903) 675-2023 | |
| Not Available |
| Full Name | Athens Dental Works |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 6300 State Highway 19 S, Athens, Texas |
| Authorized Official Name and Position | Kent Byron Boozer (DENTIST) |
| Authorized Official Contact | 9035972121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Athens Dental Works Po Box 9499 Tyler TX 75711-9499 Ph: (903) 675-0023 | Athens Dental Works 6300 State Highway 19 S Athens TX 75751-8966 Ph: (903) 675-2023 |
| NPI Number | 1134449945 |
|---|---|
| Provider Enumeration Date | 06/03/2010 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134449945 | NPI | - | NPPES |
| 213370401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
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