Organization
ALPHA OMEGA DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY L LASSITER DDS (DENTIST)
(254) 666-1366
Entity
Organization
Contact information
Practice address
211 SUN VALLEY BLVD, HEWITT, TX 76643-3571
(254) 666-1366
(254) 666-4766
Mailing address
PO BOX 428, HEWITT, TX 76643-0428
(254) 666-1366
(254) 666-4766
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
15519
TX
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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