Organization
FLOSS FT WORTH PC
Active
Other names
FLOSS Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINTON F HERZOG DDS (CEO)
(214) 871-7100
Entity
Organization
Contact information
Practice address
2421 W 7TH ST STE 103, FT WORTH, TX 76107-2325
(817) 529-1600
(817) 529-1601
Mailing address
2421 W 7TH ST STE 103, FT WORTH, TX 76107-2325
(817) 529-1600
(817) 529-1601
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
20239
TX
122300000X
Dentist
25784
TX
1223G0001X
General Practice Dentistry
Primary
20239
TX
Other
Enumeration date
03/18/2011
Last updated
03/18/2011
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