| Preece Church And Associates, Pediatric Dentistry | |
|
5700 Edwards Ranch Rd Suite 100 Fort Worth TX 76109-4127 | |
| (817) 292-2004 | |
| Not Available |
| Full Name | Preece Church And Associates, Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5700 Edwards Ranch Rd, Fort Worth, Texas |
| Authorized Official Name and Position | George Stanley Preece (MANAGER) |
| Authorized Official Contact | 8172922004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Preece Church And Associates, Pediatric Dentistry 5700 Edwards Ranch Rd Suite 100 Fort Worth TX 76109-4127 Ph: (817) 292-2004 | Preece Church And Associates, Pediatric Dentistry 5700 Edwards Ranch Rd Suite 100 Fort Worth TX 76109-4127 Ph: (817) 292-2004 |
| NPI Number | 1043754740 |
|---|---|
| Provider Enumeration Date | 12/14/2016 |
| Last Update Date | 12/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043754740 | NPI | - | NPPES |
| 1407863806 | Other | NPI, TYPE 1 | |
| 1881949592 | Other | NPI, TYPE 1 | |
| 2168825-01 | Medicaid | TX | |
| 0912362-03 | Medicaid | TX | |
| 3608952-01 | Medicaid | TX | |
| 1245251362 | Other | TX | NPI, TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 17828 (Texas) | Primary |
Miles Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6263 Mccart Ave, 201, Fort Worth, TX 76133 Phone: 817-370-1314 Fax: 817-370-1344 | |
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