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Organization
HOME TOWN DENTAL,PA
Active
Organization
HOME TOWN DENTAL,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONJIT S GURAM DDS (OWNER)
(817) 237-3222
Entity
Organization
Contact information
Practice address
6332 LAKE WORTH BLVD, LAKE WORTH, TX 76135-3602
(817) 237-3222
Mailing address
6332 LAKE WORTH BLVD, LAKE WORTH, TX 76135-3602
(817) 237-3222
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15987
TX
Other
Enumeration date
05/17/2007
Last updated
09/12/2007
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