Organization
DISTINCTIVE DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARRON CHAMBLISS (MANAGER)
(979) 297-0337
Entity
Organization
Contact information
Practice address
210 ABNER JACKSON PKWY, LAKE JACKSON, TX 77566-5124
(979) 297-0337
(979) 297-5003
Mailing address
210 ABNER JACKSON PKWY, LAKE JACKSON, TX 77566-5124
(979) 297-0337
(979) 297-5003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11238
TX
Other
Enumeration date
02/08/2011
Last updated
02/08/2011
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