| NPI | 1023161510 |
|---|---|
| Doing Business As | COMMUNITY DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DENISE RUSSELL Credentialing Coordinator 806-354-5495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 292200000X Dental Laboratory (Licence: TX R26080) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |