Organization
FULL SMILE PROSTHODONTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN AMES HODGES (CREDENTIALING SPECIALIST)
(806) 353-1055
Entity
Organization
Contact information
Practice address
4515 VAN WINKLE DR, AMARILLO, TX 79119-6423
(806) 358-0368
Mailing address
2201 CIVIC CIR STE 600, AMARILLO, TX 79109-1817
(806) 353-1055
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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