Organization
AMARILLO DENTAL ASSOCIATES
Active
Other names
Michael D Vaclav DDS & Ryan Street DDS
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL D VACLAV DDS (PARTNER)
(806) 355-7463
Entity
Organization
Contact information
Practice address
4525 VAN WINKLE, AMARILLO, TX 79119
(806) 355-7463
(806) 355-6014
Mailing address
4525 VAN WINKLE, AMARILLO, TX 79119
(806) 355-7463
(806) 355-6014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10364
TX
122300000X
Dentist
21834
TX
1223G0001X
General Practice Dentistry
21834
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095226-01
—
TX
01
—
1578606901
RYAN STREET DDS
TX
01
—
1710020177
MICHAEL VACLAV DDS
TX
Enumeration date
05/06/2008
Last updated
05/26/2011
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