Organization
BIRTH FLETCHER ORAL SURGERY KELLER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRISTI FLETCHER DDS, MS (ORTHODONTIST)
(817) 479-0541
Entity
Organization
Contact information
Practice address
4420 HERITAGE TRACE PKWY STE 300, FORT WORTH, TX 76244-8904
(817) 479-0541
Mailing address
4420 HERITAGE TRACE PKWY STE 300, FORT WORTH, TX 76244-8904
(817) 479-0541
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19486
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22279
TX
Other
Enumeration date
08/06/2013
Last updated
11/04/2013
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