Individual
JONATHAN DAVID RISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5521 BELLAIRE DR S, FORT WORTH, TX 76109-8838
(817) 569-6633
Mailing address
4902 TRAILHEAD BEND WAY APT 12305, FORT WORTH, TX 76109-1654
(812) 431-7758
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
31757
TX
Other
Enumeration date
01/26/2016
Last updated
03/28/2022
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