# DIAMOND ONE DENTAL SERVICES, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Fun Zone
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033490388
- **Authorized official:** KAYLI COFFMAN (MANAGER)
- **Authorized official phone:** (702) 204-3557

## Contact information

- **Practice address:** 10501 GATEWAY BLVD W, SUITE 107, EL PASO, TX 79925-7934
- **Practice address phone:** (915) 590-4600
- **Practice address fax:** (915) 590-4604
- **Mailing address:** 1900 DURANCE, CORINTH, TX 76210-0589
- **Mailing address phone:** (702) 204-3557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/31/2011
- **Last updated:** 02/23/2012