Organization
IMPLANTS AND ORAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IDA FERONTI (BUSINESS MANAGER)
(817) 292-3605
Entity
Organization
Contact information
Practice address
7217 HAWKINS VIEW DR STE 200, FORT WORTH, TX 76132-3928
(817) 292-3605
(817) 292-1743
Mailing address
7217 HAWKINS VIEW DR STE 200, FORT WORTH, TX 76132-3928
(817) 292-3605
(817) 292-1743
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21107
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
23154
TX
Other
Enumeration date
06/05/2015
Last updated
07/15/2015
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