Organization
PELLICANO FAMILY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUPITA MENDOZA (OFFICE MANAGER)
(214) 616-6148
Entity
Organization
Contact information
Practice address
11615 PELLICANO DR # 100, EL PASO, TX 79936-6242
(915) 444-8006
Mailing address
11615 PELLICANO DR # 100, EL PASO, TX 79936-6242
(915) 444-8006
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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