Crest Family Dental Fort Worth Pllc
NPI #1104273341 in Fort Worth, Texas
Provider Information
- NPI Number
- 1104273341
- Entity Type
- Organization
- Organization Name
- Crest Family Dental Fort Worth Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 18, 2016
- Last Updated
- May 18, 2016
Practice Location
- Address
- 220 E SEMINARY DR
- Address 2
- SUITE 100
- City
- Fort Worth
- State
- Texas
- ZIP Code
- 76115-2607
- Phone
- (817) 484-6468
Authorized Official
- Name
- LAN CHI LE, DDS
- Title
- MANAGING MEMBER
- Phone
- (214) 350-8800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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