Individual
TODD AUSTIN KOVACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
4969 E INTERSTATE 20 SERVICE RD N, SUITE 108, WILLOW PARK, TX 76087-3220
(817) 441-5000
(817) 441-5003
Mailing address
4969 E INTERSTATE 20 SERVICE RD N, SUITE 108, WILLOW PARK, TX 76087
(817) 441-5000
(817) 441-5003
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
23925
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Q1436
TX
Other
Enumeration date
02/18/2009
Last updated
03/06/2017
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