Eric Lynn Osborne Jr., DENTAL LAB TECH

Individual provider Active NPI Dental Laboratory Technician · Garden Ridge, TX

NPI 1629190897 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1629190897
Entity type
Individual (NPI type 1)
Primary specialty
Dental Laboratory Technician 126900000X
License
T62-66-0416 (VA)
Practice address
18945 FM 2252
115
Garden Ridge, TX 78266-2562
Phone
(757) 953-8635
Fax
(757) 953-8597
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Laboratory Technician 126900000X T62-66-0416 VA Yes

Addresses

Primary practice location

18945 FM 2252
115
Garden Ridge, TX 78266-2562

Mailing address

3129 Lyons Ave
Norfolk, VA 23509-2557
Phone (757) 395-0306

Other providers in Garden Ridge, TX

All providers in Garden Ridge, TX · Dental Laboratory Technician in Texas

Sources for this page

Verify at the official NPI Registry.