| Familia Dental | |
|
2402 19th St. Lubbock TX 79401-4414 | |
| (806) 368-3731 | |
| (806) 368-5925 |
| Full Name | Familia Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2402 19th St., Lubbock, Texas |
| Authorized Official Name and Position | Brandon Alexander Taylor (CREDENTIALING &PAYER RELATIONS MANA) |
| Authorized Official Contact | 8474537396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental 2050 East Algonquin Road Suite 610 Schaumburg IL 60173-4166 Ph: (847) 453-7396 | Familia Dental 2402 19th St. Lubbock TX 79401-4414 Ph: (806) 368-3731 |
| NPI Number | 1902126774 |
|---|---|
| Provider Enumeration Date | 06/03/2010 |
| Last Update Date | 06/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902126774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22535 (Texas) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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