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Pediatric Dentistry

Lubbock, Texas

Provider NPI: 1366782997

Organization Information:
Organization is not Subpart
Authorized Official:  RONEL  MCCOMBS  CREDENTIALING SPECIALIST  502-2548500

Practice Location:
3801 50TH ST  LUBBOCK, TX 79413 US
Tel: 502-254-8500  Fax: 502-245-5021

Business Mailing Address:
PO BOX 437169  LOUISVILLE, KY 40253 US
Tel: 502-254-8500  Fax: 502-245-5021

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0221XDental Providers
Pediatric Dentistry


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