Organization
MANSFIELD ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LINDSAY ALLISON JOYCE (FRONT OFFICE)
(817) 453-4404
Entity
Organization
Contact information
Practice address
1705 FOUNTAINVIEW DR #103, MANSFIELD, TX 76063
(817) 453-4404
(817) 453-4416
Mailing address
1705 FOUNTAINVIEW DR #103, MANSFIELD, TX 76063
(817) 453-4404
(817) 453-4416
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
L9710
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176821001
—
TX
Enumeration date
02/12/2008
Last updated
02/12/2008
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