Organization
FUSION DENTAL- HEWITT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA JEFFCOAT (OFFICE MANAGER)
(254) 799-4867
Entity
Organization
Contact information
Practice address
1605 HEWITT DR., SUITE 102, WACO, TX 76712
(254) 799-4867
(254) 799-4872
Mailing address
121 EASTGATE PLZ, BELLMEAD, TX 76705-2868
(254) 799-4867
(254) 799-4872
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
27552
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288519603
—
TX
Enumeration date
07/26/2017
Last updated
07/26/2017
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