| Fort Worth Dental | |
|
4620 Citylake Blvd W Fort Worth TX 76132-3695 | |
| (817) 263-0202 | |
| (817) 927-7197 |
| Full Name | Fort Worth Dental |
|---|---|
| Speciality | Dentist |
| Location | 4620 Citylake Blvd W, Fort Worth, Texas |
| Authorized Official Name and Position | Arthur Jackson Mund (OWNER) |
| Authorized Official Contact | 8172630202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Worth Dental 4620 Citylake Blvd W Fort Worth TX 76132-3695 Ph: (817) 263-0202 | Fort Worth Dental 4620 Citylake Blvd W Fort Worth TX 76132-3695 Ph: (817) 263-0202 |
| NPI Number | 1104939024 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 10/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104939024 | NPI | - | NPPES |
| 809903 | Other | TX | UNITED CONCORDIA # |
| 25DG | Other | TX | BCBS OF TX PROVIDER # |
| 84D741 | Other | TX | BCBS PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 13209 (Texas) | Primary |
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Abc Family Dental Dental Clinic Medicare: Medicare Enrolled Practice Location: 5416 Basswood Blvd, Fort Worth, TX 76137 Phone: 817-656-1215 Fax: 877-230-8349 | |
Fred L. Spradley, D.d.s., M.s.d., P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4763 Barwick Dr, Suite 107, Fort Worth, TX 76132 Phone: 817-294-5021 Fax: 817-294-9310 | |
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