# FAMILY DENTAL AND ORTHODONTICS FT WORTH ST GRAND PRAIRIE PLLC

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

## Provider details

- **NPI number:** 1629406145
- **Authorized official:** STEVEN THOMPSON (DDS)
- **Authorized official phone:** (972) 512-0285

## Contact information

- **Practice address:** 1017 FORT WORTH ST, 100, GRAND PRAIRIE, TX 75050-5402
- **Practice address phone:** (214) 412-2595
- **Mailing address:** 15110 DALLAS PKWY, SUITE 470, DALLAS, TX 75248-4635

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2013
- **Last updated:** 10/28/2013