Children'S Dental Services Of Texas, PLLC
Dentist, Pediatric Dentistry in Fort Worth, TX. Organization (NPI-2).
NPI number1699090100
StatusActive
Last updated in NPPESNov 2, 2022
Details
- NPI
- 1699090100
- Entity type
- Organization (NPI-2)
- Legal business name
- Children'S Dental Services Of Texas, PLLC
- Organization subpart
- No
- Enumeration date
- Mar 29, 2010
- Certification date
- Nov 2, 2022
- Last updated
- Nov 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | Yes |
| 1223P0221X | Dentist, Pediatric Dentistry | 20465 | TX |
Practice location
4545 Bellaire Dr S Ste 4Fort Worth, TX 76109-1811
Phone 817-731-8600 · Fax 817-207-0719
Mailing address
Po Box 55367Hurst, TX 76054-5367
Phone 214-533-8183
Authorized official
Jason A Zimmerman
Owner
8177318600
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