Provider Demographics
NPI:1699847145
Name:WEATHERFORD COSMETIC & FAMILY DENTISTRY
Entity Type:Organization
Organization Name:WEATHERFORD COSMETIC & FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMACK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-594-3806
Mailing Address - Street 1:114 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-4312
Mailing Address - Country:US
Mailing Address - Phone:817-594-3806
Mailing Address - Fax:
Practice Address - Street 1:114 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4312
Practice Address - Country:US
Practice Address - Phone:817-594-3806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty