| Timber Creek Orthodontics, P.a. | |
|
12650 N Beach St Suite 100 Fort Worth TX 76244-4243 | |
| (817) 562-3292 | |
| Not Available |
| Full Name | Timber Creek Orthodontics, P.a. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 12650 N Beach St, Fort Worth, Texas |
| Authorized Official Name and Position | Daniel C Mallory (ORTHODONTIST) |
| Authorized Official Contact | 8175623292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Timber Creek Orthodontics, P.a. 12650 N Beach St Suite 100 Fort Worth TX 76244-4243 Ph: (817) 562-3292 | Timber Creek Orthodontics, P.a. 12650 N Beach St Suite 100 Fort Worth TX 76244-4243 Ph: (817) 562-3292 |
| NPI Number | 1063798718 |
|---|---|
| Provider Enumeration Date | 10/26/2011 |
| Last Update Date | 10/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063798718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 20625 (Texas) | Primary |
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