Fourth Dimension Orthodontics & Craniofacial Orthopedics, PLLC
Dentist, Orthodontics and Dentofacial Orthopedics in Corpus Christi, TX. Organization (NPI-2).
NPI number1295976082
StatusActive
Last updated in NPPESMar 9, 2009
Details
- NPI
- 1295976082
- Entity type
- Organization (NPI-2)
- Legal business name
- Fourth Dimension Orthodontics & Craniofacial Orthopedics, PLLC
- Organization subpart
- No
- Enumeration date
- Mar 9, 2009
- Last updated
- Mar 9, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 21639 | TX | Yes |
Practice location
7717 Outreau DrCorpus Christi, TX 78414-6148
Phone 361-985-0964
Mailing address
7717 Outreau DrCorpus Christi, TX 78414-6148
Phone 361-985-0964
Authorized official
Deji V. Fashemo
Member
3619850964
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