| J De Graffenried Dentistry | |
|
238 Lawrence St Kilgore TX 75662-2610 | |
| (903) 984-0614 | |
| (903) 984-3834 |
| Full Name | J De Graffenried Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 238 Lawrence St, Kilgore, Texas |
| Authorized Official Name and Position | Jennifer Samples (HUMAN RESOURCES) |
| Authorized Official Contact | 9039840614 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J De Graffenried Dentistry 238 Lawrence St Kilgore TX 75662-2610 Ph: (903) 984-0614 | J De Graffenried Dentistry 238 Lawrence St Kilgore TX 75662-2610 Ph: (903) 984-0614 |
| NPI Number | 1962092049 |
|---|---|
| Provider Enumeration Date | 01/22/2021 |
| Last Update Date | 01/22/2021 |
| Certification Date | 01/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962092049 | NPI | - | NPPES |
| 1831205004 | Other | TX | NPI |
| 1437762622 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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