Dietmar A Kennel in Lubbock - Pediatric Dentistry
Dietmar A Kennel - NPI 1013926955
Dietmar A Kennel is a Pediatric Dentistry in Lubbock, Texas. Dietmar A Kennel practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Dietmar A Kennel is 1013926955. The last update date is 2009-02-02.
Dietmar A Kennel's current location address is 1504 Buddy Holly Ave, Lubbock, Texas. You can contact this provider via phone number 8067495437 and fax number 8067447241. The mailing address for Dietmar A Kennel is 1504 Buddy Holly Ave, Lubbock, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dietmar A Kennel |
|---|---|
| Address | 1504 Buddy Holly Ave, Lubbock, Texas |
| Phone Number | 8067495437 |
| Fax Number | 8067447241 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1013926955 |
|---|---|
| Provider Enumeration Date | 2006-08-07 |
| Last Updated Date | 2009-02-02 |
Provider Mailing Address Detail
| Address | 1504 Buddy Holly Ave |
|---|---|
| City | Lubbock |
| State | Texas (TX) |
| Post Code | 794015131 |
| Phone Number | 8067495437 |
| Fax Number | 8067447241 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 19264 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1112112-02 | TX | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Dietmar A Kennel by the Centers for Medicare & Medicaid Services?
The Dietmar A Kennel has been assigned the NPI (National Provider Identifier) 1013926955. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Dietmar A Kennel?
The Dietmar A Kennel is physically situated at 1504 Buddy Holly Ave, in the city of Lubbock, state of TX, with the postal code 794015131.
What is the Dietmar A Kennel's specialty and taxonomy code?
The Dietmar A Kennel's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
On what date did the Dietmar A Kennel receive the assignment of its 1013926955 from the Centers for Medicare & Medicaid Services?
The Dietmar A Kennel was issued its 1013926955 by the Centers for Medicare & Medicaid Services on 2006-08-07.
When was the information regarding Dietmar A Kennel most recently updated?
The details pertaining to the Dietmar A Kennel, including its address, specialty, and other relevant information, were last refreshed on 2009-02-02.