| Lustig And Young Orthodontics | |
|
601 S Main St Keller TX 76248-7029 | |
| (817) 514-1717 | |
| (817) 704-4771 |
| Full Name | Lustig And Young Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 601 S Main St, Keller, Texas |
| Authorized Official Name and Position | Jeremy Lustig (OWNER) |
| Authorized Official Contact | 8173506500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lustig And Young Orthodontics 8450 Park Vista Blvd Fort Worth TX 76137-5731 Ph: (817) 514-1717 | Lustig And Young Orthodontics 601 S Main St Keller TX 76248-7029 Ph: (817) 514-1717 |
| NPI Number | 1336906882 |
|---|---|
| Provider Enumeration Date | 03/01/2024 |
| Last Update Date | 03/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336906882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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