Organization
MABRY AND CONIGLIO DENTISTRY
Active
Other names
Michael Mabry DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA BRITTON (TREATMENT COORDINATOR)
(817) 329-6677
Entity
Organization
Contact information
Practice address
271 E SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-6272
(817) 329-6677
(817) 488-4995
Mailing address
271 E SOUTHLAKE BLVD STE 100, SOUTHLAKE, TX 76092-6272
(817) 329-6677
(817) 488-4995
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
10892
TX
261QD0000X
Dental Clinic/Center
24577
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568500197
DENTAL
TX
01
—
1639307051
DENTAL
TX
Enumeration date
01/04/2018
Last updated
01/04/2018
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