| Children's Dental Services Of Texas, Pllc | |
|
4545 Bellaire Dr S Ste 4 Fort Worth TX 76109-1811 | |
| (817) 731-8600 | |
| (817) 207-0719 |
| Full Name | Children's Dental Services Of Texas, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4545 Bellaire Dr S Ste 4, Fort Worth, Texas |
| Authorized Official Name and Position | Jason A Zimmerman (OWNER) |
| Authorized Official Contact | 8177318600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Services Of Texas, Pllc Po Box 55367 Hurst TX 76054-5367 Ph: (214) 533-8183 | Children's Dental Services Of Texas, Pllc 4545 Bellaire Dr S Ste 4 Fort Worth TX 76109-1811 Ph: (817) 731-8600 |
| NPI Number | 1699090100 |
|---|---|
| Provider Enumeration Date | 03/29/2010 |
| Last Update Date | 11/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699090100 | NPI | - | NPPES |
| 210915901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 20465 (Texas) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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J. Walton Lawrence, Jr., D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2512 Horne St Ste C, Fort Worth, TX 76107 Phone: 817-737-6601 Fax: 817-737-6446 | |
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