# IMPLANTS AND ORAL SURGERY, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699155507
- **Authorized official:** MRS. IDA FERONTI (BUSINESS MANAGER)
- **Authorized official phone:** (817) 292-3605

## Contact information

- **Practice address:** 7217 HAWKINS VIEW DR STE 200, FORT WORTH, TX 76132-3928
- **Practice address phone:** (817) 292-3605
- **Practice address fax:** (817) 292-1743
- **Mailing address:** 7217 HAWKINS VIEW DR STE 200, FORT WORTH, TX 76132-3928
- **Mailing address phone:** (817) 292-3605
- **Mailing address fax:** (817) 292-1743

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 21107 | TX | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 23154 | TX | — |

## Other

- **Enumeration date:** 06/05/2015
- **Last updated:** 07/15/2015