| Waxahachie Modern Dentistry | |
|
1400 N Highway 77 Ste 300 Waxahachie TX 75165-7847 | |
| (469) 712-2960 | |
| Not Available |
| Full Name | Waxahachie Modern Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 1400 N Highway 77 Ste 300, Waxahachie, Texas |
| Authorized Official Name and Position | Diana Do-yabut (OWNER) |
| Authorized Official Contact | 4697122960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waxahachie Modern Dentistry Po Box 920050 Dallas TX 75392-0050 | Waxahachie Modern Dentistry 1400 N Highway 77 Ste 300 Waxahachie TX 75165-7847 Ph: (469) 712-2960 |
| NPI Number | 1679118996 |
|---|---|
| Provider Enumeration Date | 11/11/2019 |
| Last Update Date | 02/08/2022 |
| Certification Date | 02/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679118996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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