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Organization
JAKE MODERY, D.D.S., P.C.
Active
Organization
JAKE MODERY, D.D.S., P.C.
Active
Other names
Modery Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JAKE MODERY D.D.S. (PRESIDENT)
(806) 731-1180
Entity
Organization
Contact information
Practice address
9200 TOWN SQUARE BLVD, SUITE 1090, AMARILLO, TX 79119-1250
(806) 731-1180
Mailing address
5902 S FANNIN ST, AMARILLO, TX 79118-8807
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30983
TX
261QD0000X
Dental Clinic/Center
30983
TX
Other
Enumeration date
07/15/2016
Last updated
09/01/2016
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