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Organization
E.Q. DENTAL
Active
Organization
E.Q. DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS YOUNG DDS (DENTIST)
(817) 741-4567
Entity
Organization
Contact information
Practice address
3529 HERITAGE TRACE PKWY, 171, FORT WORTH, TX 76244-4970
(817) 741-4567
(817) 741-4576
Mailing address
3529 HERITAGE TRACE PKWY, 171, FORT WORTH, TX 76244-4970
(817) 741-4567
(817) 741-4576
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23321
TX
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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