| Passionate Dental Wellness Pa Corporation | |
|
103 W Gibson St Ste 112 Jasper TX 75951-5062 | |
| (409) 224-8357 | |
| (409) 224-8360 |
| Full Name | Passionate Dental Wellness Pa Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 103 W Gibson St Ste 112, Jasper, Texas |
| Authorized Official Name and Position | Patrick M Ralph (OWNER) |
| Authorized Official Contact | 4092248357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passionate Dental Wellness Pa Corporation 103 W Gibson St Ste 112 Jasper TX 75951-5062 Ph: (409) 224-8357 | Passionate Dental Wellness Pa Corporation 103 W Gibson St Ste 112 Jasper TX 75951-5062 Ph: (409) 224-8357 |
| NPI Number | 1932871100 |
|---|---|
| Provider Enumeration Date | 10/05/2021 |
| Last Update Date | 10/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932871100 | NPI | - | NPPES |
| 1285642017 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Eric R. Koch Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 E. Houston St, Jasper, TX 75951 Phone: 409-384-5438 Fax: 409-384-6082 | |
Southeast Texas Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 190 N Zavalla St, Jasper, TX 75951 Phone: 409-384-5091 Fax: 409-384-5046 | |
Cammack Orthodontics, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2051 S Wheeler St Ste A, Jasper, TX 75951 Phone: 409-384-8121 Fax: 409-384-5337 | |
Jasper Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 329 E Gibson St, Jasper, TX 75951 Phone: 409-489-0066 |