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Organization
MEMBERS ONLY DENTAL PA
Active
Organization
MEMBERS ONLY DENTAL PA
Active
Other names
Bella Vita Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA FOREMAN SR. DDS (PRESIDENT)
(817) 345-6960
Entity
Organization
Contact information
Practice address
925 TROPHY CLUB DR, TROPHY CLUB, TX 76262-5582
(817) 345-6960
Mailing address
925 TROPHY CLUB DR, TROPHY CLUB, TX 76262-5582
(817) 345-6960
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23918
TX
Other
Enumeration date
05/29/2015
Last updated
05/29/2015
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