Provider Demographics
NPI:1598156143
Name:CASE FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:CASE FAMILY DENTAL PLLC
Other - Org Name:NOLAN RIVER DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-517-6453
Mailing Address - Street 1:503 N NOLAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7005
Mailing Address - Country:US
Mailing Address - Phone:817-517-6453
Mailing Address - Fax:
Practice Address - Street 1:503 N NOLAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7005
Practice Address - Country:US
Practice Address - Phone:817-517-6453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX290821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty