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General NPI Number Information
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NPI Number | 1295547800
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Entity Type | Organization
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Legal Business Name | WEATHERFORD FAMILY AND COSMETIC DENTISTRY
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 1903 FM 1189 STE 100
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City | BROCK
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State | TX
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Zip | 76087-5613
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Country | US
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Telephone | 806-690-7772
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 FALL CREEK DR
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City | WEATHERFORD
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State | TX
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Zip | 76087-1327
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Country | US
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Telephone | 806-690-7772
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | EMILY DENNIS
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Credential | DDS
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Telephone | 806-690-7772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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