| Diagnostic Dental Center Pllc | |
|
1023 N Mound St Ste D Nacogdoches TX 75961-4453 | |
| (936) 564-9401 | |
| (936) 564-3907 |
| Full Name | Diagnostic Dental Center Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1023 N Mound St Ste D, Nacogdoches, Texas |
| Authorized Official Name and Position | Sidney Jack Fowler (OWNER/DENTIST) |
| Authorized Official Contact | 9365649401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diagnostic Dental Center Pllc 1023 N Mound St Ste D Nacogdoches TX 75961-4453 Ph: (936) 564-9401 | Diagnostic Dental Center Pllc 1023 N Mound St Ste D Nacogdoches TX 75961-4453 Ph: (936) 564-9401 |
| NPI Number | 1144199639 |
|---|---|
| Provider Enumeration Date | 11/03/2025 |
| Last Update Date | 11/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144199639 | NPI | - | NPPES |
| 1659539708 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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