Organization
BRANDON TREVINO, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON JAY TREVINO DDS (OWNER)
(817) 282-3411
Entity
Organization
Contact information
Practice address
1550 NORWOOD DR, SUITE 400, HURST, TX 76054-3646
(817) 282-3411
(817) 268-3529
Mailing address
1550 NORWOOD DR, SUITE 400, HURST, TX 76054-3646
(817) 282-3411
(817) 268-3529
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23264
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189848820
—
TX
Enumeration date
11/23/2010
Last updated
11/23/2010
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