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General NPI Number Information
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NPI Number | 1699915231
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Entity Type | Organization
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Legal Business Name | SOUTHWEST DENTAL CARE OF ABILENE, PLLC
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Dates
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Enumeration Date | 02/23/2009
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Last Update Date | 02/23/2009
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Provider Practice Location Address
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Address Line | 4601 BUFFALO GAP RD STE C4
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City | ABILENE
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State | TX
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Zip | 79606-3363
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Country | US
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Telephone | 325-692-2423
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Fax | 325-692-2076
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Provider Business Mailing Address
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Address Line | 4601 BUFFALO GAP RD STE C4
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City | ABILENE
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State | TX
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Zip | 79606-3363
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Country | US
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Telephone | 325-692-2423
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Fax | 325-692-2076
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Authorized Official
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Title or Position | PARTNER
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Name | DR. CHRISTOPHER W PROCTOR
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Credential | DDS
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Telephone | 325-692-2423
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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 | 20552
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License Number State | TX
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