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Organization
JR DENTAL GROUP, PLLC
Active
Organization
JR DENTAL GROUP, PLLC
Active
Other names
Rio Grande Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE LIM (ADMINISTRATOR)
(915) 603-4633
Entity
Organization
Contact information
Practice address
11501 SOCORRO RD, SOCORRO, TX 79927-3060
(915) 603-4633
(877) 796-0125
Mailing address
11501 SOCORRO ROAD, SOCORRO, TX 79927
(915) 603-4633
(877) 796-0125
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223D0004X
Dental Anesthesiology
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
06/09/2015
Last updated
12/02/2015
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