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General NPI Number Information
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NPI Number | 1225824758
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Entity Type | Organization
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Legal Business Name | TARRANT COUNTY ORAL AND MAXILLOFACIAL SURGERY LLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 613 W HARWOOD RD
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City | HURST
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State | TX
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Zip | 76054-3161
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Country | US
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Telephone | 817-268-4108
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Fax |
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Provider Business Mailing Address
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Address Line | 613 W HARWOOD RD
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City | HURST
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State | TX
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Zip | 76054-3161
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Country | US
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Telephone | 817-268-4108
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ISHERPREET SHERGILL
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Credential | MD, DDS
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Telephone | 312-451-9563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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