| Eagle Dental Center PLLC | |
|
4009 Moores Ln Texarkana TX 75503 | |
| (903) 794-9974 | |
| (903) 793-6067 |
| Full Name | Eagle Dental Center PLLC |
|---|---|
| Speciality | Dentist |
| Location | 4009 Moores Ln, Texarkana, Texas |
| Authorized Official Name and Position | Amanda Miot (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 9037949974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Dental Center PLLC 4009 Moores Ln Texarkana TX 75503 Ph: (903) 794-9974 | Eagle Dental Center PLLC 4009 Moores Ln Texarkana TX 75503 Ph: (903) 794-9974 |
| NPI Number | 1134540628 |
|---|---|
| Provider Enumeration Date | 12/30/2013 |
| Last Update Date | 06/04/2020 |
| Certification Date | 06/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134540628 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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