# ALPHA FIRST DENTAL CLINIC P.A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225375942
- **Authorized official:** DR. OMOWUMI AKHUINI IHIONKHAN DDS (DENTIST/DIRECTOR)
- **Authorized official phone:** (903) 242-9777

## Contact information

- **Practice address:** 724 US HIGHWAY 259 N STE 101, KILGORE, TX 75662-6042
- **Practice address phone:** (903) 218-6300
- **Practice address fax:** (903) 212-4210
- **Mailing address:** 724 US HIGHWAY 259 N STE 101, KILGORE, TX 75662-6042
- **Mailing address phone:** (903) 218-6300
- **Mailing address fax:** (903) 212-4210

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 20172 | TX | Yes |

## Other

- **Enumeration date:** 01/15/2013
- **Last updated:** 07/29/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3233496-01 | — | TX |