Lustig, Jeremy Russell
Lustig, Jeremy Russell is an individual health care provider with primary practice located at 8450 Park Vista Blvd , Fort Worth TX 76137-5731. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Lustig, Jeremy Russell can be contacted via phone (817) 514-1717.Contact Information
Primary practice address
8450 Park Vista Blvd
Fort Worth TX 76137-5731
Phone: (817) 514-1717
Fax: (817) 704-4771
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 20612 | Texas |
Profile Details
| NPI number | 1760562235 |
|---|---|
| LBN Legal business name | Lustig, Jeremy Russell |
| Credentials | D.D.S., M.S., P.A. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Feb 28th, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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