Saint Apolonia Medicaid Dental Clinic No 2 of Texas PA

NPI #1477871259 in Columbus, Texas

Provider Information

NPI Number: 1477871259
Entity Type: Organization
Organization Name: Saint Apolonia Medicaid Dental Clinic No 2 of Texas PA
Primary Specialty: Dentist - General Practice
Enumeration Date: May 4, 2010
Last Updated: May 4, 2010

Practice Location

Address: 106 SHULT DR
Address 2: SUITE A/B
City: Columbus
State: Texas
ZIP Code: 78934-3016
Phone: (979) 733-8844

Authorized Official

Name: DR. ROSS W ANDERSON, D D S
Title: DENTIST/OWNER
Phone: (979) 733-8844

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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