Organization
DENTRUST DENTAL TEXAS, P.C.
Active
Parent organization
DENTRUST DENTAL TEXAS, PC
Other names
DOCS Ft. Hood
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTRUST DENTAL TEXAS, PC
Authorized official
AMANDA ANNE CLARK (DIRECTOR OF CREDENTIALING)
(267) 927-5000
Entity
Organization
Contact information
Practice address
4250 CLEAR CREEK RD, #213, FT. HOOD, TX 76544
(254) 423-9234
(254) 312-7441
Mailing address
1221 VINEWOOD DR, SEFFNER, FL 33584-4829
(813) 451-4503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18598
LC LICENSE
TX
Enumeration date
08/13/2021
Last updated
08/13/2021
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