Organization
AGAVE DENTAL CARE NORTHEAST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAKE WILLIAMS D.D.S. (DENTIST/OWNER)
(915) 755-7697
Entity
Organization
Contact information
Practice address
8815 DYER ST STE 210, EL PASO, TX 79904-2035
(915) 755-7697
Mailing address
8815 DYER ST STE 210, EL PASO, TX 79904-2035
(915) 755-7697
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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