Organization
MELANIE L THRONE DDS PA
Active
Other names
Mira Vista Cosmetic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE THRONE DDS (OWNER)
(817) 735-4700
Entity
Organization
Contact information
Practice address
6417 SOUTHWEST BLVD, FORT WORTH, TX 76132
(817) 735-4700
Mailing address
6417 SOUTHWEST BLVD, FORT WORTH, TX 76132
(817) 735-4700
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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