| Port Isabel Dental | |
|
215 W Queen Isabella Ste A Port Isabel TX 78578-2418 | |
| (956) 943-4166 | |
| Not Available |
| Full Name | Port Isabel Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 215 W Queen Isabella Ste A, Port Isabel, Texas |
| Authorized Official Name and Position | Sondra Leigh (PRESIDENT) |
| Authorized Official Contact | 9569434166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Isabel Dental Po Box 1584 Port Isabel TX 78578-1584 Ph: (281) 658-5083 | Port Isabel Dental 215 W Queen Isabella Ste A Port Isabel TX 78578-2418 Ph: (956) 943-4166 |
| NPI Number | 1144534553 |
|---|---|
| Provider Enumeration Date | 07/28/2010 |
| Last Update Date | 06/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144534553 | NPI | - | NPPES |
| 213930501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22781 (Texas) | Primary |