| Cleburne Dental Studio PLLC | |
|
1607 W Henderson St Ste K Cleburne TX 76033-4179 | |
| (817) 522-3166 | |
| Not Available |
| Full Name | Cleburne Dental Studio PLLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1607 W Henderson St Ste K, Cleburne, Texas |
| Authorized Official Name and Position | Jin Park (OWNER DENTIST) |
| Authorized Official Contact | 8175223166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleburne Dental Studio PLLC 1607 W Henderson St Ste K Cleburne TX 76033-4179 Ph: (817) 522-3166 | Cleburne Dental Studio PLLC 1607 W Henderson St Ste K Cleburne TX 76033-4179 Ph: (817) 522-3166 |
| NPI Number | 1952824468 |
|---|---|
| Provider Enumeration Date | 07/18/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 08/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952824468 | NPI | - | NPPES |
| 3427577 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 29792 (Texas) | Primary |
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