Organization
EL PASO DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. THERESE A. GUTIERREZ (OFFICE MANAGER)
(915) 855-8484
Entity
Organization
Contact information
Practice address
11625 PELLICANO DR, EL PASO, TX 79936-6242
(915) 855-8484
(915) 855-1819
Mailing address
11625 PELLICANO DR, EL PASO, TX 79936-6242
(915) 855-8484
(915) 855-1819
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13460
TX
Other
Enumeration date
03/27/2007
Last updated
08/22/2020
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