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General NPI Number Information
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NPI Number | 1316344989
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Entity Type | Organization
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Legal Business Name | LONE STAR DENTAL AND BRACES KIEST PLLC
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 1150 W KIEST BLVD STE 200
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City | DALLAS
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State | TX
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Zip | 75224-3231
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Country | US
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Telephone | 469-726-4441
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 W KIEST BLVD STE 200
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City | DALLAS
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State | TX
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Zip | 75224-3231
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Country | US
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Telephone | 469-726-4441
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. WILLIAM HOLAREN FIORE
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Credential | DDS
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Telephone | 469-726-4441
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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 | 25783
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License Number State | TX
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