# MABRY AND CONIGLIO DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michael Mabry DDS PC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346757960
- **Authorized official:** MELINDA BRITTON (TREATMENT COORDINATOR)
- **Authorized official phone:** (817) 329-6677

## Contact information

- **Practice address:** 271 E SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-6272
- **Practice address phone:** (817) 329-6677
- **Practice address fax:** (817) 488-4995
- **Mailing address:** 271 E SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-6272
- **Mailing address phone:** (817) 329-6677
- **Mailing address fax:** (817) 488-4995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 10892 | TX | Yes |
| 261QD0000X | Dental Clinic/Center | 24577 | TX | — |

## Other

- **Enumeration date:** 01/04/2018
- **Last updated:** 01/04/2018