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Organization
KILLEEN FAMILY DENTISTRY
Active
Organization
KILLEEN FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRE YASSA DDS (DIRECT OWNER)
(254) 699-6799
Entity
Organization
Contact information
Practice address
3300 E CENTRAL TEXAS EXPY, SUITE #302, KILLEEN, TX 76543-5306
(254) 699-6799
(254) 699-3465
Mailing address
3300 E CENTRAL TEXAS EXPY, SUITE #302, KILLEEN, TX 76543-5306
(254) 699-6799
(254) 699-3465
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172223301
—
TX
01
—
G60488-1
TEXAS CHIP
TX
Enumeration date
09/29/2006
Last updated
05/14/2014
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