| Abc123 Dental | |
|
200 E Main St Crowley TX 76036-2680 | |
| (817) 656-1215 | |
| (877) 687-6861 |
| Full Name | Abc123 Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 E Main St, Crowley, Texas |
| Authorized Official Name and Position | Peter Vo (DENTIST) |
| Authorized Official Contact | 8176561215 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Abc123 Dental 5416 Basswood Blvd Fort Worth TX 76137-4400 Ph: (817) 656-1215 | Abc123 Dental 200 E Main St Crowley TX 76036-2680 Ph: (817) 656-1215 |
| NPI Number | 1407105406 |
|---|---|
| Provider Enumeration Date | 09/05/2012 |
| Last Update Date | 09/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407105406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 24637 (Texas) | Primary |
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