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Organization

SOY INTY PA

Active
Other names
Northeast Dental Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DWIGHT L BAILEY D.D.S (PRESIDENT)
(915) 751-7070
Entity
Organization

Contact information

Practice address
9201 DYER ST, SUITE B, EL PASO, TX 79924-6441
(915) 751-7070
Mailing address
9201 DYER ST, SUITE B, EL PASO, TX 79924-6441
(915) 751-7070

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
24393
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1538314232
NPI TYPE 1
TX
Enumeration date
04/28/2011
Last updated
04/28/2011
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