| Forney Mirror Lake Dentistry Pllc | |
|
845 N. Fm 548 Suite 150 Forney TX 75126 | |
| (972) 200-1190 | |
| Not Available |
| Full Name | Forney Mirror Lake Dentistry Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 845 N. Fm 548, Forney, Texas |
| Authorized Official Name and Position | Justin Humphries (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 9722001190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forney Mirror Lake Dentistry Pllc 845 N. Fm 548 Suite 150 Forney TX 75126 Ph: (972) 200-1190 | Forney Mirror Lake Dentistry Pllc 845 N. Fm 548 Suite 150 Forney TX 75126 Ph: (972) 200-1190 |
| NPI Number | 1730676735 |
|---|---|
| Provider Enumeration Date | 04/16/2018 |
| Last Update Date | 04/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730676735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 29699 (Texas) | Primary |
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