| Walnut Ridge Orthodontics | |
|
3807 E Broad St Ste 101 Mansfield TX 76063-5623 | |
| (682) 300-2300 | |
| (682) 292-1373 |
| Full Name | Walnut Ridge Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3807 E Broad St Ste 101, Mansfield, Texas |
| Authorized Official Name and Position | Steven Machicek (ORTHODONTIST) |
| Authorized Official Contact | 6823002300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walnut Ridge Orthodontics 3807 E Broad St Ste 101 Mansfield TX 76063-5623 Ph: (682) 300-2300 | Walnut Ridge Orthodontics 3807 E Broad St Ste 101 Mansfield TX 76063-5623 Ph: (682) 300-2300 |
| NPI Number | 1629331608 |
|---|---|
| Provider Enumeration Date | 06/24/2012 |
| Last Update Date | 06/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629331608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 24724 (Texas) | Primary |
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