Organization
JSL DENTAL, PLLC
Active
Other names
Midland Children's Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A. YOUNGBLOOD D.D.S. (MANAGER)
(432) 682-1614
Entity
Organization
Contact information
Practice address
100 N N ST, MIDLAND, TX 79701-6409
(432) 682-1614
(432) 685-3405
Mailing address
100 N N ST, MIDLAND, TX 79701-6409
(432) 682-1614
(432) 685-3405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21026
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B-21026-01
TEXAS CHIP DENTAL SERVICE
TX
Enumeration date
02/15/2008
Last updated
02/15/2008
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