Healthcare Provider Details
I. General information
NPI: 1306087382
Provider Name (Legal Business Name): TECH TEETH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2009
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4741 BUFFALO GAP RD.
ABILENE TX
79606
US
IV. Provider business mailing address
4741 BUFFALO GAP RD.
ABILENE TX
79606
US
V. Phone/Fax
- Phone: 325-695-3300
- Fax: 325-695-9899
- Phone: 325-695-3300
- Fax: 325-695-9899
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HOLLY
ARDOIN
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 806-223-6553