Organization
ACADEMY DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES W KNOTT III D.D.S. (PRESIDENT)
(254) 982-4750
Entity
Organization
Contact information
Practice address
709 E MAIN ST, LITTLE RIVER ACADEMY, TX 76554-2605
(254) 982-4750
(254) 982-4721
Mailing address
PO BOX 546, LITTLE RIVER ACADEMY, TX 76554-0546
(254) 982-4750
(254) 982-4721
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14945
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0904500-02
—
TX
Enumeration date
11/27/2006
Last updated
06/12/2008
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