Modrall, Amy Jo
Modrall, Amy Jo is an individual health care provider with primary practice located at 2310 Fm Road 157 Suite 102, Mansfield TX 76063. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Modrall, Amy Jo can be contacted via phone (817) 477-2558.Contact Information
Primary practice address
2310 Fm Road 157 Suite 102
Mansfield TX 76063
Phone: (817) 477-2558
Fax: (817) 473-9900
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 21998 | Texas |
Profile Details
| NPI number | 1740250539 |
|---|---|
| LBN Legal business name | Modrall, Amy Jo |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years 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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