Organization
FORT WORTH DENTAL
Active
Parent organization
ARTHUR J MUND III DDS PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ARTHUR J MUND III DDS PC
Authorized official
DR. ARTHUR JACKSON MUND III D.D.S. (OWNER)
(817) 263-0202
Entity
Organization
Contact information
Practice address
4620 CITYLAKE BLVD W, FORT WORTH, TX 76132-3695
(817) 263-0202
(817) 927-7197
Mailing address
4620 CITYLAKE BLVD W, FORT WORTH, TX 76132-3695
(817) 263-0202
(817) 927-7197
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13209
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25DG
BCBS OF TX PROVIDER #
TX
01
—
809903
UNITED CONCORDIA #
TX
01
—
84D741
BCBS PROVIDER #
TX
Enumeration date
08/16/2006
Last updated
10/11/2012
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