Organization
JENNIFER CRISS, DDS,PA
Active
Other names
Nacogdoches Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNFIER CRISS DDS (PRESIDENT)
(936) 559-7200
Entity
Organization
Contact information
Practice address
1602 E STARR AVE, SUITE 203, NACOGDOCHES, TX 75961-4312
(936) 559-7200
Mailing address
1602 E STARR AVE, SUITE 203, NACOGDOCHES, TX 75961-4312
(936) 559-7200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
21417
TX
1223P0221X
Pediatric Dentistry
Primary
21417
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16283102
—
TX
Enumeration date
05/13/2015
Last updated
05/13/2015
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