Organization
CRYSTAL DENTAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN T. LE D.D.S. (OWNER)
(817) 473-6200
Entity
Organization
Contact information
Practice address
2880 HIGHWAY 157 N, SUITE 102, MANSFIELD, TX 76063-8849
(817) 473-6200
(817) 473-6207
Mailing address
1114 E. SEMINARY DR, FORT WORTH, TX 76115
(817) 921-0883
(888) 600-6547
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21298
TX
Other
Enumeration date
08/05/2006
Last updated
03/06/2018
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