Organization
ABC123 DENTAL IN KELLER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANGELA FLORES (OFFICE MANAGER)
(817) 496-2343
Entity
Organization
Contact information
Practice address
460 KELLER PKWY STE E, KELLER, TX 76248-2370
(817) 496-2343
(817) 665-3822
Mailing address
6426 MEADOWBROOK DR, FORT WORTH, TX 76112-5123
(817) 496-2343
(817) 665-3822
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
24570
TX
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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