Organization
TIMBER CREEK ORTHODONTICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL C MALLORY D.D.S., M.S. (ORTHODONTIST)
(817) 562-3292
Entity
Organization
Contact information
Practice address
12650 N BEACH ST, SUITE 100, FORT WORTH, TX 76244-4243
(817) 562-3292
Mailing address
12650 N BEACH ST, SUITE 100, FORT WORTH, TX 76244-4243
(817) 562-3292
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
20625
TX
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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