# ALTA MERE DENTAL PLLC

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

## Provider details

- **NPI number:** 1659913788
- **Authorized official:** MARK ANTHONY RESASCO (OWNER)
- **Authorized official phone:** (480) 646-6004

## Contact information

- **Practice address:** 550 ALTA MERE DR, FORT WORTH, TX 76114-4053
- **Practice address phone:** (480) 646-6004
- **Mailing address:** 550 ALTA MERE DR, FORT WORTH, TX 76114-4053

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 10/10/2019
- **Last updated:** 10/10/2019