National Provider Identifier Database

CRYSTAL DENTAL OF BURLESON
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

CRYSTAL DENTAL OF BURLESON
664 SW WILSHIRE BLVD
BURLESON, TX76028-5851
Phone: 817-426-3331
Fax: 817-426-3337
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X
General Practice 1223G0001X

* Indicates primary specialty

NPI Profile & details for CRYSTAL DENTAL OF BURLESON

NPI Number 1508037128
Legal business name
LBN
CRYSTAL DENTAL OF BURLESON
Authorized official BRIAN LE - (DENTIST/OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/23/2008
Last updated 07/07/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • TX License #: 21298
  • TX Medicaid: 1730177619

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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