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Organization
HOME TOWN DENTAL ALLIANCE
Active
Organization
HOME TOWN DENTAL ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONJIT GURAM (BUSINESS OWNER)
(817) 834-2600
Entity
Organization
Contact information
Practice address
8901 TEHAMA, SUITE 119, FORTH WORTH, TX 76177
(817) 834-2600
Mailing address
3825 YUCCA AVE, SUITE 101, FORTH WORTH, TX 76111
(817) 834-2600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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