| Brent Cornelius Dds Pa | |
|
123 Keller Pkwy Ste 100 Keller TX 76248-2255 | |
| (817) 431-4200 | |
| Not Available |
| Full Name | Brent Cornelius Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 123 Keller Pkwy Ste 100, Keller, Texas |
| Authorized Official Name and Position | Brent Cornelius (PRESIDENT) |
| Authorized Official Contact | 8174314200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Cornelius Dds Pa 123 Keller Pkwy Ste 100 Keller TX 76248-2255 Ph: (817) 431-4200 | Brent Cornelius Dds Pa 123 Keller Pkwy Ste 100 Keller TX 76248-2255 Ph: (817) 431-4200 |
| NPI Number | 1891713863 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 07/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891713863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19334 (Texas) | Primary |
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