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Organization
FOSSUM DENTAL GROUP
Active
Organization
FOSSUM DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RCHARD FOSSUM D.D.S (ORGANIZER)
(254) 778-3900
Entity
Organization
Contact information
Practice address
201 W FM 2410 RD, HARKER HEIGHTS, TX 76548-1709
(254) 699-3565
Mailing address
2534 BLUE MEADOW DR, TEMPLE, TX 76502-7924
(254) 778-3900
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22304
TX
Other
Enumeration date
05/08/2007
Last updated
08/22/2020
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