# FLOSS FT WORTH PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FLOSS Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760781595
- **Authorized official:** DR. CLINTON F HERZOG DDS (CEO)
- **Authorized official phone:** (214) 871-7100

## Contact information

- **Practice address:** 2421 W 7TH ST STE 103, FT WORTH, TX 76107-2325
- **Practice address phone:** (817) 529-1600
- **Practice address fax:** (817) 529-1601
- **Mailing address:** 2421 W 7TH ST STE 103, FT WORTH, TX 76107-2325
- **Mailing address phone:** (817) 529-1600
- **Mailing address fax:** (817) 529-1601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 20239 | TX | — |
| 122300000X | Dentist | 25784 | TX | — |
| 1223G0001X | General Practice Dentistry | 20239 | TX | Yes |

## Other

- **Enumeration date:** 03/18/2011
- **Last updated:** 03/18/2011