My Local Texas Dental Practice, Pllc

NPI #1679201024 in Sealy, Texas

Provider Information

NPI Number
1679201024
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
Aug 12, 2022
Last Updated
Aug 12, 2022

Practice Location

Address
226 4TH ST
City
Sealy
State
Texas
ZIP Code
77474-2726
Phone
(719) 266-2717

Authorized Official

Name
SILAS CHARLES ERICKSON
Title
CREDENTIALING SPECIALIST
Phone
(720) 353-4903

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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