St Paul Dental Clinic

LBN: St Paul Children'S Medical Corporation
St Paul Dental Clinic is an health care organization with primary practice located at 132 S Horace Ave , Tyler TX 75702-6159. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. St Paul Children'S Medical Corporation can be contacted via phone (903) 593-7607, or through Young, David via phone (903) 531-9455.

Contact Information

Primary practice address
132 S Horace Ave Tyler TX 75702-6159
Phone: (903) 593-7607
Fax: (903) 593-3965
Website:
Map and Directions
Authorized official contact:
Name: Young, David
Phone: (903) 531-9455

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1467689307
LBN Legal business name St Paul Children'S Medical Corporation
DBA Doing business as St Paul Dental Clinic
Authorized official Young, David
Entity Organization
Organization subpart 1 No
Enumeration date Jun 18th, 2009
Last updated Mar 8th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1467689307 NPPES
Texas MEDICAID 203763201
Texas Other G6063601
Texas Other 203763202

Popular Providers