| My Teeth Dental Orthodontics Pllc | |
|
2063 Town East Mall Ste 1036 Mesquite TX 75150-4118 | |
| (716) 348-9855 | |
| Not Available |
| Full Name | My Teeth Dental Orthodontics Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2063 Town East Mall Ste 1036, Mesquite, Texas |
| Authorized Official Name and Position | Omar Fetouh (CEO) |
| Authorized Official Contact | 7163489855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Teeth Dental Orthodontics Pllc 2063 Town East Mall Ste 1036 Mesquite TX 75150-4118 Ph: (716) 348-9855 | My Teeth Dental Orthodontics Pllc 2063 Town East Mall Ste 1036 Mesquite TX 75150-4118 Ph: (716) 348-9855 |
| NPI Number | 1053769356 |
|---|---|
| Provider Enumeration Date | 05/26/2016 |
| Last Update Date | 04/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053769356 | NPI | - | NPPES |
| 1891810263 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 24314 (Texas) | Primary |
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