MEDICARE: CRYSTAL DENTAL, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21298	TX

General Provider Information

NPI Number	:	1780693960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRYSTAL DENTAL, P.A.

Provider Business Mailing Address
First Line	:	1114 E. SEMINARY DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76115
Country	:	US
Telephone Number	:	817-921-0883
Fax Number	:	888-600-6547

Provider Business Practice Location Address
First Line	:	2880 HIGHWAY 157 N
Second Line	:	SUITE 102
City	:	MANSFIELD
State	:	TX
Zip	:	76063-8849
Country	:	US
Telephone Number	:	817-473-6200
Fax Number	:	817-473-6207

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRIAN T. LE
Credential	:	D.D.S.
Telephone Number	:	817-473-6200

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	03/06/2018

Similar Medicare Providers

1508037128 — CRYSTAL DENTAL OF BURLESON
Practice Location Address:

664 SW WILSHIRE BLVD
BURLESON, TX
76028-5851

Practice Phone: 817-426-3331
Practice Fax: 817-426-3337

1376840306 — CRYSTAL DENTAL OF FORT WORTH, P.C.
Practice Location Address:

1114 E SEMINARY DR
FORT WORTH, TX
76115-2830

Practice Phone: 817-473-6200
Practice Fax:

1598610792 — SIMON NGUYEN
Practice Location Address:

2700 E BROAD ST
MANSFIELD, TX
76063-5899

Practice Phone: 682-242-2000
Practice Fax:

1275488355 — BRIONNA HOPE
Practice Location Address:

305 REGENCY PKWY STE 601
MANSFIELD, TX
76063-7306

Practice Phone: 817-217-4730
Practice Fax:

1598610453 — KATE WALKER PA-C
Practice Location Address:

2700 E BROAD ST STE 522
MANSFIELD, TX
76063-5899

Practice Phone: 214-821-9600
Practice Fax:

1548614340 — JESSICA ANDERSON FNP
Practice Location Address:

2200 E BROAD ST STE 100
MANSFIELD, TX
76063-6597

Practice Phone: 817-473-9473
Practice Fax: 817-473-3473

Directions to “CRYSTAL DENTAL, P.A. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.