# CHISHOLM TRAIL ORAL SURGERY PLLC

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

## Provider details

- **NPI number:** 1811733769
- **Authorized official:** CRAIG HARRISON (OWNER / PROVIDER)
- **Authorized official phone:** (817) 484-4778

## Contact information

- **Practice address:** 7040 HARRIS PKWY STE 140, FORT WORTH, TX 76132-4218
- **Practice address phone:** (903) 530-7382
- **Mailing address:** 4137 TRAILS END DR APT 2018, FORT WORTH, TX 76116-0785
- **Mailing address phone:** (903) 530-7382

## Taxonomy

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

## Other

- **Enumeration date:** 07/01/2024
- **Last updated:** 10/29/2024