411 Dental PC Dba Harris Creek Dental
Organization Active NPI General Practice Dentistry · MC Gregor, TX
NPI 1124489935 · NPPES record last updated Mar 8, 2016
Key facts
- NPI
- 1124489935
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 25535 (TX)
- Legal business name
- 411 DENTAL PC DBA HARRIS CREEK DENTAL
- Practice address
- 27487 W Highway 84
MC Gregor, TX 76657-3717 - Phone
- (254) 848-9566
- NPI assigned
- Mar 8, 2016
- Organization subpart
- No
Authorized official
- Name
- Sam M Baber, DDS
- Title
- President
- Phone
- (254) 848-9566
National Provider Directory
Locations
27487 W Highway 84
McGregor, TX 76657
Phone (254) 848-7474
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 25535 | TX | Yes |
Addresses
Primary practice location
27487 W Highway 84
MC Gregor, TX 76657-3717
Mailing address
27487 W Highway 84
MC Gregor, TX 76657-3717
Other providers in MC Gregor, TX
All providers in MC Gregor, TX · General Practice Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.