Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Oral & Maxillofacial Network, PLLC

Organization Oral and Maxillofacial Pathology Dentistry · NPI 1417170655

Oral & Maxillofacial Network, PLLC is an Oral and Maxillofacial Pathology Dentistry in Fort Worth, Texas. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 920-6936
Fax: (817) 702-1035
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X
Oral and Maxillofacial Pathology Dentistry Taxonomy 1223P0106X

Record details

NPI number1417170655
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Holly Portwood — Chief Operating Officer · (817) 920-6936
NPI enumeratedApril 10, 2007
Last updated in NPPESJuly 8, 2024
Certification dateJuly 8, 2024
Mailing address1500 S Main St, Fort Worth, TX 76104-4917

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