| Concho Valley Endodontics | |
|
2014 W Beauregard Ave San Angelo TX 76901-3813 | |
| (325) 947-3040 | |
| (806) 797-2460 |
| Full Name | Concho Valley Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 2014 W Beauregard Ave, San Angelo, Texas |
| Authorized Official Name and Position | Chad R Southard (ADMINISTRATOR) |
| Authorized Official Contact | 8067974455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Concho Valley Endodontics 2014 W Beauregard Ave San Angelo TX 76901-3813 Ph: (325) 947-3040 | Concho Valley Endodontics 2014 W Beauregard Ave San Angelo TX 76901-3813 Ph: (325) 947-3040 |
| NPI Number | 1174081301 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 03/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174081301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | () | Primary |
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