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Organization
AGGIELAND DENTAL ASSOCIATES, PC
Active
Organization
AGGIELAND DENTAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROXANE G MLCAK-SPENCE (VP)
(979) 696-4511
Entity
Organization
Contact information
Practice address
2700 EARL RUDDER FRWY S, SUITE 1900, COLLEGE STATION, TX 77845-5032
(979) 696-4511
Mailing address
2700 EARL RUDDER FRWY S, SUITE 1900, COLLEGE STATION, TX 77845-5032
(979) 696-4511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15745
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82D692
BCBS PROVIDER #
TX
Enumeration date
05/03/2007
Last updated
08/22/2020
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