MEDICARE: ALLIANCE ORAL & MAXILLOFACIAL SURGERY, 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	16535	TX

General Provider Information

NPI Number	:	1881870970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE ORAL & MAXILLOFACIAL SURGERY, P.A.

Provider Business Mailing Address
First Line	:	9415 N BEACH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-9059
Country	:	US
Telephone Number	:	817-741-2200
Fax Number	:	817-741-2216

Provider Business Practice Location Address
First Line	:	9415 N BEACH ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-9059
Country	:	US
Telephone Number	:	817-741-2200
Fax Number	:	817-741-2216

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID EDWARD PARMER
Credential	:	DDS, MD
Telephone Number	:	817-741-2200

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	03/15/2021

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