Organization
DIAMOND ONE DENTAL SERVICES, PLLC
Active
Other names
Dental Fun Zone
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLI COFFMAN (MANAGER)
(702) 204-3557
Entity
Organization
Contact information
Practice address
10501 GATEWAY BLVD W, SUITE 107, EL PASO, TX 79925-7934
(915) 590-4600
(915) 590-4604
Mailing address
1900 DURANCE, CORINTH, TX 76210-0589
(702) 204-3557
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/31/2011
Last updated
02/23/2012
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