# PICKETT FAMILY DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pickett Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205314150
- **Authorized official:** DR. TYSON PICKETT DDS (OWNER)
- **Authorized official phone:** (817) 431-5514

## Contact information

- **Practice address:** 1135 KELLER PKWY, KELLER, TX 76248-3614
- **Practice address phone:** (817) 431-5514
- **Practice address fax:** (817) 431-8048
- **Mailing address:** 1135 KELLER PKWY, KELLER, TX 76248-3614
- **Mailing address phone:** (817) 431-5514
- **Mailing address fax:** (817) 431-8048

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 31668 | TX | Yes |

## Other

- **Enumeration date:** 08/02/2018
- **Last updated:** 08/02/2018