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Organization
AB4, PLLC
Active
Organization
AB4, PLLC
Active
Other names
Old Betsy Dental Sleep Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
BROCK BENNION DDS (MANAGING MEMBER)
(817) 476-4537
Entity
Organization
Contact information
Practice address
104 S OLD BETSY RD STE A, KEENE, TX 76059-2462
(817) 476-4537
(817) 476-4536
Mailing address
104 S OLD BETSY RD STE A, KEENE, TX 76059-2462
(817) 476-4537
(817) 476-4536
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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