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Organization
LIFEWAY DENTAL
Active
Organization
LIFEWAY DENTAL
Active
Parent organization
ALSBURY DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALSBURY DENTAL
Authorized official
BLAKE FOUST DDS (OWNER)
(817) 587-8888
Entity
Organization
Contact information
Practice address
505 E HWY 67, ALVARADO, TX 76009
(817) 587-8888
Mailing address
505 E HWY 67, ALVARADO, TX 76009
(817) 587-8888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14855
TX
Other
Enumeration date
03/29/2014
Last updated
03/29/2014
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