| Heritage Trace Dental, Pa | |
|
4160 Heritage Trace Pkwy Suite 408 Keller TX 76248-1312 | |
| (817) 741-4288 | |
| Not Available |
| Full Name | Heritage Trace Dental, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4160 Heritage Trace Pkwy, Keller, Texas |
| Authorized Official Name and Position | Brett Nielsen (VICE PRESIDENT) |
| Authorized Official Contact | 8177414288 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Trace Dental, Pa 4160 Heritage Trace Pkwy Suite 408 Keller TX 76248-1313 Ph: (817) 741-4288 | Heritage Trace Dental, Pa 4160 Heritage Trace Pkwy Suite 408 Keller TX 76248-1312 Ph: (817) 741-4288 |
| NPI Number | 1013164284 |
|---|---|
| Provider Enumeration Date | 08/19/2008 |
| Last Update Date | 08/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013164284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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