Organization
BOP DENTAL SPECIALISTS
Active
Other names
Brazos Kids Dental
Organization subpart
No
Provider details
NPI number
Authorized official
AARON BLACKWELDER DDS (MANAGER)
(254) 224-6008
Entity
Organization
Contact information
Practice address
1605 LAKE SUCCESS DR, WACO, TX 76710-2908
(254) 224-6008
Mailing address
1121 LAKE AIR DR, WACO, TX 76710-4417
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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