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Organization
AGAVE DENTAL CARE NORTH EAST, PLLC
Active
Organization
AGAVE DENTAL CARE NORTH EAST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE RUSSELL WILLIAMS D.D.S. (OWNER/DENTIST)
(915) 755-7697
Entity
Organization
Contact information
Practice address
8815 DYER ST SUITE 210, EL PASO, TX 79904
(915) 755-7697
(915) 751-1056
Mailing address
8815 DYER ST SUITE 210, EL PASO, TX 79904
(915) 755-7697
(915) 751-1056
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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