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Organization
FAMILIA DENTAL LUBBOCK PLLC
Active
Organization
FAMILIA DENTAL LUBBOCK PLLC
Active
Other names
FAMILIA DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON ALEXANDER TAYLOR CPCS (CREDENTIALING &PAYER RELATIONS MANA)
(847) 453-7396
Entity
Organization
Contact information
Practice address
2402 19TH ST., LUBBOCK, TX 79401-4414
(806) 368-3731
(806) 368-5925
Mailing address
2050 EAST ALGONQUIN ROAD, SUITE 610, SCHAUMBURG, IL 60173-4166
(847) 453-7396
(847) 453-7396
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
22535
TX
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/03/2010
Last updated
06/25/2021
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