M Dental Granbury, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

M DENTAL GRANBURY, PLLC

Practice address

500 W Pearl St
Granbury, TX 76048-2044

Phone

(817) 275-4817

NPI assigned

Feb 11, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lee Charles Mercer Jr., DDS

Title

Owner

Phone

(817) 275-4817

Specialties & licenses 1

Addresses

Other names 1

• Granbury Park Dental Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1396201778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N FIELDER RD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760124636",
            "telephone_number": "817-275-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W PEARL ST",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482044",
            "telephone_number": "817-275-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M DENTAL GRANBURY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "MERCER",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-275-4817",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granbury Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Al Ludwick, RPH
• Mason Matthew Luedeker, DDS
• Lumin ER Granbury
• Andrea N Lynch, M.S., CCC-SLP
• Ryan Warren Lynch, DC
• Making Waves Pediatric Therapy Clinic LLC
• Bridget T Maldonado, FNP
• Corey J. Mark, M.D.
• Becky E Marquardt
• Steven Ryan Marsh, OTR

• Dental Clinic/Center in Granbury, TX
• Providers in Granbury, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.