Organization
CELEBRITY DENTAL PC
Active
Other names
Celebrity Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOURDES HERNANDEZ (OFFICE MANAGER)
(214) 275-4808
Entity
Organization
Contact information
Practice address
5651 E LANCASTER AVE, FORT WORTH, TX 76112-6430
(214) 275-4808
Mailing address
5651 E LANCASTER AVE, FORT WORTH, TX 76112-6430
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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