| Small Town Dental | |
|
2021 W Irving Blvd Irving TX 75061-4353 | |
| (972) 254-6000 | |
| (972) 254-6061 |
| Full Name | Small Town Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2021 W Irving Blvd, Irving, Texas |
| Authorized Official Name and Position | Anthony B Henegar (OWNER/PRESIDENT) |
| Authorized Official Contact | 9722546000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Small Town Dental 2021 W Irving Blvd Irving TX 75061-4353 Ph: (972) 254-6000 | Small Town Dental 2021 W Irving Blvd Irving TX 75061-4353 Ph: (972) 254-6000 |
| NPI Number | 1366614182 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 04/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366614182 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18083 (Texas) | Primary |
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