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Organization
DIAMOND ONE DENTAL SERVICES, PLLC
Active
Organization
DIAMOND ONE DENTAL SERVICES, PLLC
Active
Other names
Dental Fun Zone
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLI COFFMAN (MANAGER)
(702) 204-3557
Entity
Organization
Contact information
Practice address
10501 GATEWAY BLVD W, SUITE 107, EL PASO, TX 79925-7934
(915) 590-4600
(915) 590-4604
Mailing address
1900 DURANCE, CORINTH, TX 76210-0589
(702) 204-3557
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/31/2011
Last updated
02/23/2012
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