The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
TX license #24789taxonomy 1223S0112X
Identifiers
Type
Value
Notes
01 (TX)
1306018320
INDIVIDUAL NPI
05 (TX)
206992419
01 (TX)
288152601
FACILITY TPI MEDICAID
01 (TX)
OPT0005
MEDICARE OPT OUT PTAN
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Trinity Valley Oral Surgery & Dental Implant Center
Type code 5recorded 2012-01-17
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
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