| Dentrust Dental Texas, P.c. | |
|
13405 Immanuel Rd Ste B Pflugerville TX 78660-8337 | |
| (267) 927-5000 | |
| (267) 927-5007 |
| Full Name | Dentrust Dental Texas, P.c. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 13405 Immanuel Rd Ste B, Pflugerville, Texas |
| Authorized Official Name and Position | Dan Decarlo (VP FINANCE) |
| Authorized Official Contact | 2673625869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentrust Dental Texas, P.c. 6097 Easton Rd Pipersville PA 18947-1810 Ph: (267) 927-5000 | Dentrust Dental Texas, P.c. 13405 Immanuel Rd Ste B Pflugerville TX 78660-8337 Ph: (267) 927-5000 |
| NPI Number | 1376631101 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 09/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376631101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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