Organization
WALNUT RIDGE ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN MACHICEK D.D.S. (ORTHODONTIST)
(682) 300-2300
Entity
Organization
Contact information
Practice address
3807 E BROAD ST STE 101, MANSFIELD, TX 76063-5623
(682) 300-2300
(682) 292-1373
Mailing address
3807 E BROAD ST STE 101, MANSFIELD, TX 76063-5623
(682) 300-2300
(682) 292-1373
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
24724
TX
Other
Enumeration date
06/24/2012
Last updated
06/24/2012
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