| NPI | 1760813232 | 
|---|---|
| Doing Business As | FIELDER PARK DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | LEE CHARLES MERCER Owner 817-275-4817  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 122300000X Dentist (Licence: TX 20975)  | 
| Additional Taxonomies | 122300000X Dentist (Licence: TX 9945)  | 
| 122300000X Dentist (Licence: TX 29082)  | |
| Enumeration Date | 2013-12-09 | 
| Last Update Date | 2013-12-09 |