NPI 1265157978 · live from the CMS NPI Registry
8901 Tehama Ridge Pkwy PLLC
Dentist, General Practice in Fort Worth, TX. National Provider Identifier 1265157978, active.
NPI record
| NPI | 1265157978 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 8901 Tehama Ridge Pkwy Ste 119, Fort Worth, TX 76177 |
| Practice phone | 214-317-4039 |
| Mailing address | 2401 E Randol Mill Rd, Arlington, TX 76011 |
| Enumerated | October 5, 2022 |
| Last updated | October 7, 2022 |
| Authorized official | Gunjan Dhir, Owner |
| Other names | Fresh Smiles Of Fort Worth Alliance |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.