Southlake Dental Corp
Southlake Dental Corp is a Periodontics in Fort Worth, Texas. Licensed in Texas. Registered with an NPI since 2007.
- Licensed in
- TX
- In the registry since
- 2007
What do these letters mean?
- Corp — Corporation
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1124 S Lake St Ste BFort Worth, TX 76104
Phone: (817) 336-1166
Fax: (817) 336-1180
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Periodontics (primary) | Taxonomy 1223P0300X · Licence 9930 (TX) |
|---|
Record details
| NPI number | 1154544740 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Dwain Matelski — President · (817) 336-1166 |
| Other names | Dwain E Matelski Dds Periodontist |
| NPI enumerated | April 11, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 1124 S Lake Street, Suite B, Fort Worth, TX 76104 |
Other providers in Fort Worth
-
Dr. Kent Healy, DDS
4900 Overton Ridge Blvd Ste 213, Fort Worth, TX 76132-1914 · (210) 844-9300
-
Sarah Kelly, DDS
3701 Hulen St, Fort Worth, TX 76107-6803 · (817) 738-3510
-
Dr. Nolan Joseph Laborde III, DDS
3701 Hulen St Ste B, Fort Worth, TX 76107-6803 · (817) 738-3151
-
Dr. Vijaya Lakshmi Pavan Molli, DDS
4021 Reggis Ct Ste 313, Fort Worth, TX 76155-3958 · (817) 764-1496
-
Dr. Nicholas Tyler Tipton, DDS
3833 Camp Bowie Blvd, Fort Worth, TX 76107-3355 · (817) 672-9867