Organization · NPI-2

Browntraildental

Dentist · Bedford, TX

NPI number1801114491
StatusActive
Last updated in NPPESMay 7, 2010

Details

NPI
1801114491
Entity type
Organization (NPI-2)
Legal business name
Browntraildental
Organization subpart
No
Enumeration date
May 7, 2010
Last updated
May 7, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist23212TXYes

Practice location

1404 Brown Trl
#c
Bedford, TX 76022-6497

Phone 817-510-2960 · Fax 817-510-2967

Mailing address

1404 Brown Trl
#c
Bedford, TX 76022-6497

Phone 817-510-2960 · Fax 817-510-2967

Authorized official

Lam Hoang
Director
8175102960

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