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Organization
HOMETOWN DENTAL AT RIDGEMAR
Active
Organization
HOMETOWN DENTAL AT RIDGEMAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELODY VARGAS (INUSRANCE COORDINATOR)
(817) 834-2600
Entity
Organization
Contact information
Practice address
2374 MALL CIR, FORT WORTH, TX 76116-1543
(817) 543-2222
(817) 543-2299
Mailing address
3825 YUCCA AVE, SUITE 121, FORT WORTH, TX 76111-6067
(817) 834-2600
(817) 834-2607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15987
TX
Other
Enumeration date
05/02/2012
Last updated
05/02/2012
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