Organization
TERRY T. ANGEVINE, DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY T. ANGEVINE D.D.S (OWNER/DR)
(972) 436-1513
Entity
Organization
Contact information
Practice address
651 CROSS TIMBERS ROAD, SUITE 103, FLOWER MOUND, TX 75028
(972) 436-1513
(972) 436-0618
Mailing address
651 CROSS TIMBERS ROAD, SUITE 103, FLOWER MOUND, TX 75028
(972) 436-1513
(972) 436-0618
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T58Z
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/02/2009
Last updated
09/02/2009
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