Organization · Type 2 NPI
Southlake Dental Corp
Periodontics · Fort Worth, TX
NPI number
1154544740
Active
Practice location
1124 S Lake Street, Suite B
Fort Worth, TX 76104
Fax (817) 336-1180
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Periodontics Primary | 1223P0300X | 9930 (TX) |
Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Other periodontics providers in Fort Worth
About NPI 1154544740
Southlake Dental Corp's National Provider Identifier is 1154544740, issued on Apr 11, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Fort Worth, TX. The record was last updated on Aug 22, 2020.