| Brant Boling, Dds, Pllc | |
|
1429 Clear Lake Rd Ste 700 Weatherford TX 76086-5805 | |
| (817) 598-0835 | |
| (817) 598-0845 |
| Full Name | Brant Boling, Dds, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1429 Clear Lake Rd Ste 700, Weatherford, Texas |
| Authorized Official Name and Position | Brant Boling (MANAGER) |
| Authorized Official Contact | 8175980835 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brant Boling, Dds, Pllc 1429 Clear Lake Rd Ste 700 Weatherford TX 76086-5805 Ph: (817) 598-0835 | Brant Boling, Dds, Pllc 1429 Clear Lake Rd Ste 700 Weatherford TX 76086-5805 Ph: (817) 598-0835 |
| NPI Number | 1790916146 |
|---|---|
| Provider Enumeration Date | 08/03/2009 |
| Last Update Date | 01/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790916146 | NPI | - | NPPES |
| 1962664-04 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 019240 (Texas) | Primary |
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