# EAGLE DENTAL CENTER OF TEXARKANA PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Eagle Dental Center PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134540628
- **Authorized official:** AMANDA MIOT (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (903) 794-9974

## Contact information

- **Practice address:** 4009 MOORES LN, TEXARKANA, TX 75503
- **Practice address phone:** (903) 794-9974
- **Practice address fax:** (903) 793-6067
- **Mailing address:** 4009 MOORES LN, TEXARKANA, TX 75503
- **Mailing address phone:** (903) 794-9974
- **Mailing address fax:** (903) 793-6067

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 12/30/2013
- **Last updated:** 06/04/2020