# AZTECA DENTAL PLLC

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

## Provider details

- **NPI number:** 1235455353
- **Authorized official:** DR. HAMID JAY SHAFI DDS (OWNER)
- **Authorized official phone:** (818) 419-5001

## Contact information

- **Practice address:** 4858 SOUTH FWY, FORT WORTH, TX 76115-3901
- **Practice address phone:** (817) 534-7325
- **Practice address fax:** (817) 534-4429
- **Mailing address:** 4858 SOUTH FWY, FORT WORTH, TX 76115-3901
- **Mailing address phone:** (817) 534-7325
- **Mailing address fax:** (817) 534-4429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 04/14/2010
- **Last updated:** 04/14/2010