Individual
JEROD WILSON BRAZEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
696 N FIELDER RD STE 102, ARLINGTON, TX 76012-3861
(817) 261-9772
Mailing address
4200 BRYANT IRVIN RD STE 129, BENBROOK, TX 76109-4212
(817) 731-6964
(817) 731-4273
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27094
TX
1223P0221X
Pediatric Dentistry
Primary
27094
TX
Other
Enumeration date
06/25/2011
Last updated
03/17/2018
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