Organization
FAMILIA DENTAL LUBBOCK PLLC
Active
Other names
FAMILIA DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANDON ALEXANDER TAYLOR CPCS (CREDENTIALING &PAYER RELATIONS MANA)
(847) 453-7396
Entity
Organization
Contact information
Practice address
2402 19TH ST., LUBBOCK, TX 79401-4414
(806) 368-3731
(806) 368-5925
Mailing address
2050 EAST ALGONQUIN ROAD, SUITE 610, SCHAUMBURG, IL 60173-4166
(847) 453-7396
(847) 453-7396
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
22535
TX
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/03/2010
Last updated
06/25/2021
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