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Organization

PARKWAY DENTAL PROFESSIONALS

Active
Other names
The Parkway Dentist
Organization subpart
No

Provider details

NPI number
Authorized official
DARLIN LACOUR (OFFICE MANAGER)
(817) 735-1616
Entity
Organization

Contact information

Practice address
4200 BRYANT IRVIN RD. STE. 101, FORT WORTH, TX 76109
(817) 735-1616
(817) 735-8132
Mailing address
4200 BRYANT IRVIN RD. STE. 101, FORT WORTH, TX 76109
(817) 735-1616
(817) 735-8132

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
22699
TX

Other

Enumeration date
04/16/2015
Last updated
04/16/2015
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