Organization
FARWELL DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOYCE ROE IVINS JR. D.D.S. (OWNER)
(806) 481-3336
Entity
Organization
Contact information
Practice address
303 3RD ST, FARWELL, TX 79325-4669
(806) 481-3336
(806) 481-3339
Mailing address
PO BOX 800, FARWELL, TX 79325-0800
(806) 481-3336
(806) 481-3339
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
11608
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0087520-1
—
TX
Enumeration date
08/08/2013
Last updated
08/08/2013
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