Organization
FORT WORTH COSMETIC & FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERE SIERRA REDD (OFFICE COORDINATOR)
(817) 737-6601
Entity
Organization
Contact information
Practice address
5720 LOCKE AVE, FORT WORTH, TX 76107
(817) 737-6601
Mailing address
5720 LOCKE AVE, FORT WORTH, TX 76107
(817) 737-6601
(817) 737-6446
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
TX
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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