Provider Demographics
NPI:1245571504
Name:WESTWORTH VILLAGE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:WESTWORTH VILLAGE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:KRISTEN
Authorized Official - Last Name:MURREY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-732-2995
Mailing Address - Street 1:6628 WESTWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTWORTH VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:76114
Mailing Address - Country:US
Mailing Address - Phone:817-732-2995
Mailing Address - Fax:
Practice Address - Street 1:6628 WESTWORTH BLVD
Practice Address - Street 2:
Practice Address - City:WESTWORTH VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:76114
Practice Address - Country:US
Practice Address - Phone:817-732-2995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty