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Organization
MODERN DENTAL INCORPORATED
Active
Organization
MODERN DENTAL INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARSHA AMANDA D.M.D (PRESIDENT)
(866) 371-5205
Entity
Organization
Contact information
Practice address
1821 N ZARAGOSA, SUITE 207-316, EL PASO, TX 79936-7912
(866) 371-5205
Mailing address
1821 N ZARAGOSA, SUITE 207-316, EL PASO, TX 79936-7912
(866) 371-5205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25146
TX
Other
Enumeration date
12/05/2010
Last updated
02/03/2011
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