| Dentrust Dental Texas, P.c. | |
|
4250 Clear Creek Rd #213 Ft. Hood TX 76544 | |
| (254) 423-9234 | |
| (254) 312-7441 |
| Full Name | Dentrust Dental Texas, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4250 Clear Creek Rd, Ft. Hood, Texas |
| Authorized Official Name and Position | Amanda Anne Clark (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 2679275000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentrust Dental Texas, P.c. 1221 Vinewood Dr Seffner FL 33584-4829 Ph: (813) 451-4503 | Dentrust Dental Texas, P.c. 4250 Clear Creek Rd #213 Ft. Hood TX 76544 Ph: (254) 423-9234 |
| NPI Number | 1407521180 |
|---|---|
| Provider Enumeration Date | 08/13/2021 |
| Last Update Date | 08/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407521180 | NPI | - | NPPES |
| 18598 | Other | TX | LC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |