| Cementum Llc | |
|
3205 N University Dr Ste B Nacogdoches TX 75965-2683 | |
| (936) 657-0110 | |
| Not Available |
| Full Name | Cementum Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3205 N University Dr Ste B, Nacogdoches, Texas |
| Authorized Official Name and Position | Kelly Ann Bateman (OWNER/DENTIST) |
| Authorized Official Contact | 9366570110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cementum Llc 3205 N University Dr Ste B Nacogdoches TX 75965-2683 Ph: (936) 657-0110 | Cementum Llc 3205 N University Dr Ste B Nacogdoches TX 75965-2683 Ph: (936) 657-0110 |
| NPI Number | 1811577455 |
|---|---|
| Provider Enumeration Date | 04/08/2021 |
| Last Update Date | 04/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811577455 | NPI | - | NPPES |
| 1801104427 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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