| Crockett Dental Care Pllc | |
|
1050 E Loop 304 Ste 120 Crockett TX 75835-1800 | |
| (936) 544-3554 | |
| Not Available |
| Full Name | Crockett Dental Care Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1050 E Loop 304 Ste 120, Crockett, Texas |
| Authorized Official Name and Position | Joseph Henderson Holcomb (PRESIDENT) |
| Authorized Official Contact | 9365443554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crockett Dental Care Pllc 1050 E Loop 304 Ste 120 Crockett TX 75835-1800 Ph: (936) 544-3554 | Crockett Dental Care Pllc 1050 E Loop 304 Ste 120 Crockett TX 75835-1800 Ph: (936) 544-3554 |
| NPI Number | 1407217664 |
|---|---|
| Provider Enumeration Date | 03/16/2016 |
| Last Update Date | 03/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407217664 | NPI | - | NPPES |
| 1942318035 | Other | TX | HUMANA |
| 1598873614 | Other | TX | HUMANA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 8092 (Texas) | Secondary |
| 122300000X | Dentist | 17145 (Texas) | Primary |
Lol Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 E Loop 304, Suite 100, Crockett, TX 75835 Phone: 314-477-2752 |