# AGAVE DENTAL CARE NORTHEAST, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851056576
- **Authorized official:** DR. JAKE WILLIAMS D.D.S. (DENTIST/OWNER)
- **Authorized official phone:** (915) 755-7697

## Contact information

- **Practice address:** 8815 DYER ST STE 210, EL PASO, TX 79904-2035
- **Practice address phone:** (915) 755-7697
- **Mailing address:** 8815 DYER ST STE 210, EL PASO, TX 79904-2035
- **Mailing address phone:** (915) 755-7697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/08/2021
- **Last updated:** 11/08/2021