| Tahoka Dentistry Pllc | |
|
2428 Lockwood Street Tahoka TX 79373 | |
| (806) 601-0333 | |
| (806) 601-0339 |
| Full Name | Tahoka Dentistry Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2428 Lockwood Street, Tahoka, Texas |
| Authorized Official Name and Position | Benjamin Roy Menlove (PRESIDENT) |
| Authorized Official Contact | 8014482346 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tahoka Dentistry Pllc 1310 Essex Lane Wolfforth TX 79382 Ph: (801) 448-2346 | Tahoka Dentistry Pllc 2428 Lockwood Street Tahoka TX 79373 Ph: (806) 601-0333 |
| NPI Number | 1033914965 |
|---|---|
| Provider Enumeration Date | 02/14/2025 |
| Last Update Date | 02/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033914965 | NPI | - | NPPES |
| 00185523 | Medicaid | NM | |
| 440696902 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |