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Sunny Side Of The Street Pediatric Dentistry

Dentist, Pediatric Dentistry in Fort Worth, TX. Organization (NPI-2).

NPI number1649972035
StatusActive
Last updated in NPPESMar 29, 2023

Details

NPI
1649972035
Entity type
Organization (NPI-2)
Legal business name
Sunny Side Of The Street Pediatric Dentistry
Organization subpart
No
Enumeration date
Mar 20, 2023
Certification date
Mar 29, 2023
Last updated
Mar 29, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223P0221X Dentist, Pediatric Dentistry––Yes

Practice location

5725 Golden Triangle Blvd
Fort Worth, TX 76244-4473

Phone 817-799-8778 · Fax 817-799-6671

Mailing address

5801 Golden Triangle Blvd Ste 103
Fort Worth, TX 76244-4411

Phone 817-799-8778 · Fax 817-799-6671

Authorized official

Tyffani Tynneil Palmer
Owner
8177998778

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Other Pediatric Dentistry providers in Fort Worth, TX

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