NPI 1174910111

Parkway Dental Professionals

Organisation Preferred Provider Organization Fort Worth, TX

Practice location

Address: 4200 Bryant Irvin Rd. STE. 101, Fort Worth, TX 76109
Phone: (817) 735-1616
Fax: (817) 735-8132

Authorised official

Name: Darlin Lacour
Title: Office Manager
Phone: (817) 735-1616

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 22699 (TX)

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Registry record

NPI: 1174910111
Entity type: Organization
NPI issued: 16 Apr 2015
Record last updated: 16 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.