Organization
TRINITY VALLEY ORAL SURGERY & DENTAL IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM RALPH PHILLIPS MD (OWNER)
(469) 689-0704
Entity
Organization
Contact information
Practice address
215 S. FM 548, SUITE C, FORNEY, TX 75126
(469) 689-0704
(469) 689-0709
Mailing address
215 S. FM 548, SUITE C, FORNEY, TX 75126
(469) 689-0704
(469) 689-0709
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225036759
NPI
TX
Enumeration date
02/05/2008
Last updated
02/05/2008
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