The Light Family Dental And Implant Dentistry Pllc | |
8214 Fm-78 Suite 105 Converse TX 78109 | |
(210) 920-4963 | |
(210) 783-8656 |
Full Name | The Light Family Dental And Implant Dentistry Pllc |
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Speciality | Dentist |
Location | 8214 Fm-78, Converse, Texas |
Authorized Official Name and Position | Andrew Akindutire (DMD) |
Authorized Official Contact | 3017955013 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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The Light Family Dental And Implant Dentistry Pllc 8214 Fm-78 Suite 105 Converse TX 78109 Ph: (210) 920-4963 | The Light Family Dental And Implant Dentistry Pllc 8214 Fm-78 Suite 105 Converse TX 78109 Ph: (210) 920-4963 |
NPI Number | 1912617929 |
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Provider Enumeration Date | 11/30/2022 |
Last Update Date | 12/19/2022 |
Medicare PECOS PAC ID | 6800268517 |
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Medicare Enrollment ID | O20230206003043 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912617929 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Provider Name | Andrew Akindutire |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1104470368 PECOS PAC ID: 7618349325 Enrollment ID: I20230206003089 |
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