| Lifetime And Cosmetic Dentistry | |
|
5040 N Tarrant Pkwy Suite 118 Fort Worth TX 76244-5389 | |
| (817) 750-5433 | |
| (817) 750-5431 |
| Full Name | Lifetime And Cosmetic Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5040 N Tarrant Pkwy, Fort Worth, Texas |
| Authorized Official Name and Position | Sonya Austin (OWNER) |
| Authorized Official Contact | 8177505433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime And Cosmetic Dentistry 5040 N Tarrant Pkwy Suite 118 Fort Worth TX 76244-5389 Ph: (817) 750-5433 | Lifetime And Cosmetic Dentistry 5040 N Tarrant Pkwy Suite 118 Fort Worth TX 76244-5389 Ph: (817) 750-5433 |
| NPI Number | 1841521879 |
|---|---|
| Provider Enumeration Date | 01/14/2010 |
| Last Update Date | 01/14/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841521879 | NPI | - | NPPES |
| 21561 | Other | TX | 1223G0001X-DENTIST-GENERAL PRACTICE |
| 21381 | Other | TX | 1223G0001X-DENTIST-GENERAL PRACTISE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21381 (Texas) | Primary |
| 1223G0001X | Dentist - General Practice | 21561 (Texas) | Secondary |
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