Organization
ORAL CANCER RECONSTRUCTIVE SURGEONS OF TEXAS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY BROWN DDS (OWNER)
(817) 431-6995
Entity
Organization
Contact information
Practice address
359 KELLER PKWY, KELLER, TX 76248-2206
(817) 431-6995
Mailing address
359 KELLER PKWY, KELLER, TX 76248-2206
(817) 431-6995
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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