# CARLOS G. TELLO DDS MS PA

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

## Provider details

- **NPI number:** 1679627590
- **Authorized official:** DR. CARLOS G TELLO DDS MS (PRESIDENT)
- **Authorized official phone:** (817) 281-9141

## Contact information

- **Practice address:** 5340 DAVIS BLVD, FORT WORTH, TX 76180
- **Practice address phone:** (817) 281-9141
- **Mailing address:** 5340 DAVIS BLVD, FORT WORTH, TX 76180
- **Mailing address phone:** (817) 281-9141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 19305 | TX | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 02/07/2012