| NPI | 1992249239 |
|---|---|
| Doing Business As | FOSSIL CREEK FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | JAMIE E GOMEZ Office Manager 817-281-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 29655) |
| Enumeration Date | 2016-12-06 |
| Last Update Date | 2021-10-20 |