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General NPI Number Information
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NPI Number | 1699288423
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Entity Type | Organization
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Legal Business Name | YELLOW HOUSE DENTAL & IMPLANT CENTER, PLLC
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 2420 QUAKER AVE STE 104
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City | LUBBOCK
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State | TX
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Zip | 79410-1837
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Country | US
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Telephone | 806-797-0341
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Fax | 806-797-1607
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Provider Business Mailing Address
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Address Line | 2420 QUAKER AVE STE 104
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City | LUBBOCK
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State | TX
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Zip | 79410-1837
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Country | US
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Telephone | 806-797-0341
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Fax | 806-797-1607
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Authorized Official
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Title or Position | PATIENT RELATIONS
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Name | VICKI LAUREN MYERS
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Credential |
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Telephone | 806-797-0341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | TX
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