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3006 H G Mosley Pkwy Longview TX 75605-2948 | |
| (903) 753-2151 | |
| (903) 753-0884 |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3006 H G Mosley Pkwy, Longview, Texas |
| Authorized Official Name and Position | Patrick Briscoe (OWNER/DOCTOR) |
| Authorized Official Contact | 9032614711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
627 Turtle Creek Dr Tyler TX 75701-1832 Ph: (903) 597-6372 | 3006 H G Mosley Pkwy Longview TX 75605-2948 Ph: (903) 753-2151 |
| NPI Number | 1114234556 |
|---|---|
| Provider Enumeration Date | 09/07/2010 |
| Last Update Date | 09/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114234556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 9121 (Texas) | Primary |
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