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General NPI Number Information
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NPI Number | 1245614080
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Entity Type | Organization
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Legal Business Name | CROSSPOINTE DENTAL AND ORTHODONTICS, INC
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Dates
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Enumeration Date | 07/10/2015
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 2041 HIGHWAY 287 N SUITE 105
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City | MANSFIELD
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State | TX
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Zip | 76063-8842
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Country | US
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Telephone | 682-302-3283
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Fax |
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Provider Business Mailing Address
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Address Line | 7903 MOSSTREE DR
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City | ARLINGTON
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State | TX
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Zip | 76001-6142
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ASHLEY COERVER
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Credential | DDS
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Telephone | 405-205-2275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30647
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License Number State | TX
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