| Fort Worth Children's Dentistry | |
|
5521 Bellaire Dr S Suite 210 Fort Worth TX 76109-8838 | |
| (817) 569-6633 | |
| (817) 569-6636 |
| Full Name | Fort Worth Children's Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5521 Bellaire Dr S, Fort Worth, Texas |
| Authorized Official Name and Position | Andrew M Jamison (DOCTOR/OWNER) |
| Authorized Official Contact | 8175696633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Worth Children's Dentistry 5521 Bellaire Dr S Suite 210 Fort Worth TX 76109-8838 Ph: (817) 569-6633 | Fort Worth Children's Dentistry 5521 Bellaire Dr S Suite 210 Fort Worth TX 76109-8838 Ph: (817) 569-6633 |
| NPI Number | 1194104505 |
|---|---|
| Provider Enumeration Date | 05/19/2015 |
| Last Update Date | 05/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194104505 | NPI | - | NPPES |
| 0913279-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 21557 (Texas) | Primary |
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