| Del Mar Dental | |
|
6726 Camp Bowie Blvd Fort Worth TX 76116-7113 | |
| (951) 205-5140 | |
| Not Available |
| Full Name | Del Mar Dental |
|---|---|
| Speciality | Dentist |
| Location | 6726 Camp Bowie Blvd, Fort Worth, Texas |
| Authorized Official Name and Position | Jason Troy Bacon (MANAGER) |
| Authorized Official Contact | 9512055140 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Del Mar Dental 6726 Camp Bowie Blvd Fort Worth TX 76116-7113 Ph: (951) 205-5140 | Del Mar Dental 6726 Camp Bowie Blvd Fort Worth TX 76116-7113 Ph: (951) 205-5140 |
| NPI Number | 1275804023 |
|---|---|
| Provider Enumeration Date | 01/24/2012 |
| Last Update Date | 01/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275804023 | NPI | - | NPPES |
| 1996837 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 24381 (Texas) | Primary |
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