| Southeast Texas Dental Center | |
|
190 N Zavalla St Jasper TX 75951-4119 | |
| (409) 384-5091 | |
| (409) 384-5046 |
| Full Name | Southeast Texas Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 190 N Zavalla St, Jasper, Texas |
| Authorized Official Name and Position | Carrie Camille Jordan (BUSINESS MANAGER) |
| Authorized Official Contact | 4093845091 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Texas Dental Center 190 N Zavalla St Jasper TX 75951-4119 Ph: (409) 384-5091 | Southeast Texas Dental Center 190 N Zavalla St Jasper TX 75951-4119 Ph: (409) 384-5091 |
| NPI Number | 1356696058 |
|---|---|
| Provider Enumeration Date | 07/18/2012 |
| Last Update Date | 07/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356696058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Texas) | Primary |
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