Organization
TEXAS ORTHODONTICS FOR KIDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN R WALDER DDS MS (PRESIDENT/ ORTHODONTIST)
(972) 564-6064
Entity
Organization
Contact information
Practice address
215 S FM 548, A, FORNEY, TX 75126
(972) 564-6064
Mailing address
215 S FM 548, A, FORNEY, TX 75126
(972) 564-6064
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0020802
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0024486
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306969894
NPI
TX
01
—
1861628638
NPI
TX
Enumeration date
03/12/2010
Last updated
03/12/2010
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