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116 E Interstate 20 Ste 155 Weatherford TX 76087-8535 | |
(817) 818-4975 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 116 E Interstate 20 Ste 155, Weatherford, Texas |
Authorized Official Name and Position | Bonventure Kuloba (MANAGING DENTIST) |
Authorized Official Contact | 8178184975 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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116 E Interstate 20 Ste 155 Weatherford TX 76087-8535 Ph: (817) 818-4975 | 116 E Interstate 20 Ste 155 Weatherford TX 76087-8535 Ph: (817) 818-4975 |
NPI Number | 1770347767 |
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Provider Enumeration Date | 02/09/2024 |
Last Update Date | 04/29/2024 |
Identifier | Type | State | Issuer |
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1770347767 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Kyle Meason Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2035 Fort Worth Hwy Ste 600, Weatherford, TX 76086 Phone: 817-341-7825 | |