# FORT WORTH ENDODONTICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083979462
- **Authorized official:** DR. JOHN WALKER LOEFFELHOLZ D.D.S. , M.S. (MEMBER)
- **Authorized official phone:** (817) 735-1981

## Contact information

- **Practice address:** 4545 BELLAIRE DR S STE 8, FORT WORTH, TX 76109-1811
- **Practice address phone:** (817) 735-1981
- **Mailing address:** 4545 BELLAIRE DR S STE 8, FORT WORTH, TX 76109-1811
- **Mailing address phone:** (817) 735-1981

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 25792 | TX | Yes |

## Other

- **Enumeration date:** 07/11/2012
- **Last updated:** 07/11/2012