Lifeway Dental

NPI #1194143016 in Alvarado, Texas

Provider Information

NPI Number
1194143016
Entity Type
Organization
Organization Name
Lifeway Dental
Subpart
Yes (part of a larger organization)
Parent Organization
ALSBURY DENTAL
Primary Specialty
Dentist
Enumeration Date
Mar 29, 2014
Last Updated
Mar 29, 2014

Practice Location

Address
505 E HWY 67
State
Texas
ZIP Code
76009
Phone
(817) 587-8888

Authorized Official

Name
BLAKE FOUST, DDS
Title
OWNER
Phone
(817) 587-8888

Specialties & Taxonomy Codes

Specialty
Dentist

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Organizations

Provider Name
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