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Organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Active
Organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Active
Parent organization
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Other names
Sealy Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY LOCAL TEXAS DENTAL PRACTICE, PLLC
Authorized official
SILAS CHARLES ERICKSON (CREDENTIALING SPECIALIST)
(720) 353-4903
Entity
Organization
Contact information
Practice address
226 4TH ST, SEALY, TX 77474-2726
(719) 266-2717
(719) 213-2311
Mailing address
6110 BARNES RD, COLORADO SPRINGS, CO 80922-2600
(719) 266-2717
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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