# FOUR SEASONS DENTAL PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Saskia C Vaughan DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619072261
- **Authorized official:** MRS. SASKIA CHRISTINA VAUGHAN DDS (DENTIST/PRESIDENT/SECRETARY)
- **Authorized official phone:** (940) 328-1131

## Contact information

- **Practice address:** 510 SE 1ST ST, MINERAL WELLS, TX 76067
- **Practice address phone:** (940) 328-1131
- **Mailing address:** 501 E HUBBARD ST, MINERAL WELLS, TX 76067-5415
- **Mailing address phone:** (940) 328-1131
- **Mailing address fax:** (940) 328-1131

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 16103 | TX | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 16103 | LICENSE (TSBDE) | TX |