| Brident Dental Associates Pc | |
|
4200 South Fwy Ste 805 Fort Worth TX 76115-1437 | |
| (817) 924-4220 | |
| (817) 632-3007 |
| Full Name | Brident Dental Associates Pc |
|---|---|
| Speciality | Dentist |
| Location | 4200 South Fwy Ste 805, Fort Worth, Texas |
| Authorized Official Name and Position | Maribel Zamora (ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 7145713104 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brident Dental Associates Pc 530 S Main St Ste 600 Orange CA 92868-4544 Ph: (714) 480-3000 | Brident Dental Associates Pc 4200 South Fwy Ste 805 Fort Worth TX 76115-1437 Ph: (817) 924-4220 |
| NPI Number | 1467926337 |
|---|---|
| Provider Enumeration Date | 01/14/2019 |
| Last Update Date | 01/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467926337 | NPI | - | NPPES |
| G60850 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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