| Magnolia Modern Dentistry, PC | |
|
32822 Fm 2978 Suite 1300 Magnolia TX 77354 | |
| (832) 552-1559 | |
| Not Available |
| Full Name | Magnolia Modern Dentistry, PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 32822 Fm 2978, Magnolia, Texas |
| Authorized Official Name and Position | James De Vera (OWNER) |
| Authorized Official Contact | 8325521559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Modern Dentistry, PC Po Box 920050 Dallas TX 75392-0050 | Magnolia Modern Dentistry, PC 32822 Fm 2978 Suite 1300 Magnolia TX 77354 Ph: (832) 552-1559 |
| NPI Number | 1902644461 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902644461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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