Organization
BRENT CORNELIUS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT CORNELIUS DDS (PRESIDENT)
(817) 431-4200
Entity
Organization
Contact information
Practice address
123 KELLER PKWY STE 100, KELLER, TX 76248-2255
(817) 431-4200
Mailing address
123 KELLER PKWY STE 100, KELLER, TX 76248-2255
(817) 431-4200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19334
TX
Other
Enumeration date
07/18/2006
Last updated
07/17/2019
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