| Lufkin Dentistry PLLC | |
|
1218 Ellis Ave Lufkin TX 75904-3326 | |
| (936) 634-6119 | |
| (936) 639-3442 |
| Full Name | Lufkin Dentistry PLLC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1218 Ellis Ave, Lufkin, Texas |
| Authorized Official Name and Position | Amanda Lightfoot (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2543381468 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lufkin Dentistry PLLC 1218 Ellis Ave Lufkin TX 75904-3326 Ph: (936) 634-6119 | Lufkin Dentistry PLLC 1218 Ellis Ave Lufkin TX 75904-3326 Ph: (936) 634-6119 |
| NPI Number | 1104464585 |
|---|---|
| Provider Enumeration Date | 12/16/2019 |
| Last Update Date | 12/16/2019 |
| Certification Date | 12/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104464585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | () | Primary |
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