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Organization
12900 EASTLAKE PLLC
Active
Organization
12900 EASTLAKE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASIE GARCIA (BILLING OPERATION)
(915) 219-4713
Entity
Organization
Contact information
Practice address
12900 EASTLAKE BLVD, EL PASO, TX 79928
(915) 219-4713
Mailing address
10510 MONTWOOD DR STE B, EL PASO, TX 79935-2717
(915) 219-4713
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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