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Organization

CROWLEY FAMILY DENTAL CENTER

Active
Other names
Modern Family Dental Hwy 1187
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ODALIS PATRICIA SKUR DDS (DOCTOR)
(817) 297-0058
Entity
Organization

Contact information

Practice address
779 FM 1187 E, CROWLEY, TX 76036-4346
(807) 297-0058
(817) 297-7811
Mailing address
779 FM 1187 E, CROWLEY, TX 76036-4346
(807) 297-0058
(817) 297-7811

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
20899
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1235351495
DELTA DENTAL
TX
01
1447431523
DELTA DENTAL
TX
01
1801093844
DELTA DENTAL
TX
Enumeration date
02/26/2014
Last updated
02/26/2014
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