My Local Texas Dental Practice, Pllc

NPI #1225605132 in Spring Branch, Texas

Provider Information

NPI Number
1225605132
Entity Type
Organization
Organization Name
My Local Texas Dental Practice, Pllc
Subpart
Yes (part of a larger organization)
Parent Organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Primary Specialty
Dentist - General Practice
Enumeration Date
Jun 9, 2021
Last Updated
Jun 9, 2021

Practice Location

Address
20540 HIGHWAY 46 W STE 100
State
Texas
ZIP Code
78070-6825
Phone
(830) 980-8099

Authorized Official

Name
MICHELLE JOHNSON
Title
CREDENTIALING SPECIALIST
Phone
(509) 315-8338

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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