COUNTRY DAY DENTAL NPI 1003186495

NPI Information

NPI: 1003186495
Provider Name: COUNTRY DAY DENTAL
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4255 BRYANT IRVIN RD
SUITE 111
FORT WORTH, TX
ZIP 76109
Phone: (817) 731-9487
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COUNTRY DAY DENTAL is a dental clinic center in Fort Worth, TX. COUNTRY DAY DENTAL NPI is 1003186495. The provider is registered as an organization entity type.

The provider's business location address is:

4255 BRYANT IRVIN RD
SUITE 111
FORT WORTH, TX
ZIP 76109-233
Phone: (817) 731-9487
Fax: (817) 731-2846

The provider's authorized official is Richard Scott Mcdonald .
The authorized official title is Owner/dentist and has the following contact phone number (817) 731-9487.

The enumeration date for this NPI number is 1/3/2012 and was last updated on 1/3/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	12997	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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