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General NPI Number Information
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NPI Number | 1184010712
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Entity Type | Organization
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Legal Business Name | EL PASO SUNNY HILLS FAMILY DENTAL, PLLC
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Dates
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Enumeration Date | 04/10/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 1801 N 14TH ST EP SUNNY HILLS FAMILY DENTAL
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City | LAMESA
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State | TX
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Zip | 79331-2809
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Country | US
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Telephone | 806-332-5090
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Fax |
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Provider Business Mailing Address
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Address Line | 6555 N MESA ST EP SUNNY HILLS FAMILY DENTAL
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City | EL PASO
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State | TX
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Zip | 79912
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Country | US
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Telephone | 915-584-5457
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMIE A CHIANG-MCCASLAND
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Credential | DDS
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Telephone | 806-332-5090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19992
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License Number State | TX
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