Organization
KOVACH ORAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD A KOVACH DDS, MD (MANAGING MEMBER)
(817) 441-5000
Entity
Organization
Contact information
Practice address
4969 E INTERSTATE 20 SERVICE RD N, WILLOW PARK, TX 76087-3220
(817) 441-5000
(817) 441-5003
Mailing address
4969 E INTERSTATE 20 SERVICE RD N, WILLOW PARK, TX 76087-3220
(817) 441-5000
(817) 441-5003
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
23925
TX
Other
Enumeration date
08/10/2015
Last updated
03/03/2017
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