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General NPI Number Information
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NPI Number | 1497396873
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Entity Type | Organization
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Legal Business Name | ALLWYN DENTAL PLLC
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Dates
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Enumeration Date | 10/07/2019
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Last Update Date | 12/30/2019
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Provider Practice Location Address
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Address Line | 2347 HIGHWAY 35 N
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City | ROCKPORT
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State | TX
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Zip | 78382-5702
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Country | US
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Telephone | 361-777-0700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1286
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City | PORTLAND
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State | TX
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Zip | 78374-1184
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Country | US
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Telephone | 361-777-0700
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SUMEET MALHOTRA
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Credential |
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Telephone | 361-777-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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