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Organization
WESTERN DENTAL
Active
Organization
WESTERN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOSSAIN DEZHAM (OWNER)
(817) 457-4141
Entity
Organization
Contact information
Practice address
1501 HANDLEY DR, FORT WORTH, TX 76112
(817) 457-4141
(817) 457-4142
Mailing address
1501 HANDLEY DR, FORT WORTH, TX 76112-3328
(817) 457-4141
(817) 457-4142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19711
TX
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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