Permian Basin Dental Group

LBN: Permian Basin Dental Group
Permian Basin Dental Group is an health care organization with primary practice located at 2631 Faudree Rd Unit B , Odessa TX 79765-8530. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Permian Basin Dental Group can be contacted via phone (432) 563-1760, or through Higgins, Kenneth Welby via phone (432) 563-1760.

Contact Information

Primary practice address
2631 Faudree Rd Unit B Odessa TX 79765-8530
Phone: (432) 563-1760
Fax: (432) 563-1763
Website:
Map and Directions
Authorized official contact:
Name: Higgins, Kenneth Welby Doctor of Dental Surgery (DDS)
Phone: (432) 563-1760

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 12663 Texas

Profile Details

NPI number 1972625978
LBN Legal business name Permian Basin Dental Group
DBA Doing business as
Authorized official Higgins, Kenneth Welby Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2007
Last updated Aug 8th, 2012 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972625978 NPPES
Texas MEDICAID 177458001

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