| Sunny Side Of The Street Pediatric Dentistry | |
|
5725 Golden Triangle Blvd Fort Worth TX 76244-4473 | |
| (817) 799-8778 | |
| (817) 799-6671 |
| Full Name | Sunny Side Of The Street Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 5725 Golden Triangle Blvd, Fort Worth, Texas |
| Authorized Official Name and Position | Tyffani Tynneil Palmer (OWNER) |
| Authorized Official Contact | 8177998778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunny Side Of The Street Pediatric Dentistry 5801 Golden Triangle Blvd Ste 103 Fort Worth TX 76244-4411 Ph: (817) 799-8778 | Sunny Side Of The Street Pediatric Dentistry 5725 Golden Triangle Blvd Fort Worth TX 76244-4473 Ph: (817) 799-8778 |
| NPI Number | 1649972035 |
|---|---|
| Provider Enumeration Date | 03/20/2023 |
| Last Update Date | 03/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649972035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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