Organization
CRANIOFACIAL PAIN ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES RICHARD POLSON R.PH., D.D.S. (DIRECTOR)
(817) 283-0025
Entity
Organization
Contact information
Practice address
2121 MARTIN DR, BEDFORD, TX 76021-5993
(817) 283-0025
Mailing address
2121 MARTIN DR, BEDFORD, TX 76021-5993
(817) 283-0025
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
14974
TX
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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