Lustig and Young Orthodontics

NPI #1528825072 in Azle, Texas

Provider Information

NPI Number: 1528825072
Entity Type: Organization
Organization Name: Lustig and Young Orthodontics
Subpart: Yes (part of a larger organization)
Parent Organization: FPDS LYO PLLC
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Mar 1, 2024
Last Updated: Mar 1, 2024

Practice Location

Address: 1025 BOYD RD STE 100
City: Azle
State: Texas
ZIP Code: 76020-2517
Phone: (817) 514-1717

Authorized Official

Name: JEREMY LUSTIG
Title: OWNER
Phone: (817) 350-6500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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