Organization
CHILDREN'S DENTAL DEPOT PA
Active
Other names
Nannis Little Smiles Dentistry For Children PA
Organization subpart
No
Provider details
NPI number
Authorized official
JOLIE PLAGENS (BILLING AND INSURANCE COORD)
(915) 855-2337
Entity
Organization
Contact information
Practice address
833 W MAIN ST, GUN BARREL CITY, TX 75156-5312
(903) 686-9992
Mailing address
11165 LA QUINTA PL, EL PASO, TX 79936-5221
(915) 855-2337
(915) 503-1012
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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