Unknown Individual – Pediatric Dentistry, NPI 1720083983
Pediatric Dentistry
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
2921, Lackland Road, Fort Worth, Tarrant County, Texas, 76116, United States
STE 201
FORT WORTH, TX 761164173
Phone: (817) 732-2821
Fax: (817) 763-0419
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 76116)
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