Organization
AB4, PLLC
Active
Other names
Old Betsy Dental Sleep Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
BROCK BENNION DDS (MANAGING MEMBER)
(817) 476-4537
Entity
Organization
Contact information
Practice address
104 S OLD BETSY RD STE A, KEENE, TX 76059-2462
(817) 476-4537
(817) 476-4536
Mailing address
104 S OLD BETSY RD STE A, KEENE, TX 76059-2462
(817) 476-4537
(817) 476-4536
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/28/2026
Last updated
05/28/2026
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