Organization
SOUTH PLAINS PEDIATRIC DENTAL GROUP
Active
Parent organization
SOUTH PLAINS PEDIATRIC DENTAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH PLAINS PEDIATRIC DENTAL GROUP
Authorized official
DR. JOHN S JOHNSON DDS (PARTNER/OWNER)
(806) 795-9503
Entity
Organization
Contact information
Practice address
5102 SALEM AVE, LUBBOCK, TX 79414-4036
(806) 795-9503
(806) 795-2920
Mailing address
5102 SALEM AVE, LUBBOCK, TX 79414-4036
(806) 795-9503
(806) 795-2920
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
17087
TX
Other
Enumeration date
12/14/2007
Last updated
12/14/2007
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