Organization
CENTRAL TEXAS ORTHODONTIC SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA L. KERNS DDS, MS (DOCTOR)
(254) 399-9800
Entity
Organization
Contact information
Practice address
5180 W WACO DR, WACO, TX 76710-7024
(254) 399-9800
(254) 399-9700
Mailing address
5180 W WACO DR, WACO, TX 76710-7024
(254) 399-9800
(254) 399-9700
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
17577
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
188559
TX
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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