Fort Worth Dental

NPI 1104939024 - Dentist - 122300000X

NPI Details
NPI 1104939024
Enumeration Date 08/16/2006
Last Updated 10/11/2012
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name ARTHUR JACKSON ARTHUR
Position OWNER
Phone (817) 263-0202
Fax (817) 927-7197
Practice Location
4620 CITYLAKE BLVD W
FORT WORTH TX, 76132-3695, US
Phone (817) 263-0202
Fax (817) 927-7197
Business Location
4620 CITYLAKE BLVD W
FORT WORTH TX, 76132-3695, US
Phone (817) 263-0202
Fax (817) 927-7197
Toxanomy
Taxonomy Code 122300000X
License State Texas
License Number 13209
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According to our database, Fort Worth Dental NPI is 1104939024, taxonomy code is 122300000X and license number is 13209, license state is located at Texas. Fort Worth Dental physically located at 4620 Citylake Blvd W, Fort Worth TX, 76132-3695. NPI Number 1033115704 has the healthcare provider type.

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1104939024 NPI number is provided on an as is basis without warranty of any kind. 1104939024 is maintained by the National Plan & Provider Enumeration System. The contents of Fort Worth Dental are for informational purposes only.