Organization
JAMISON PEDIATRIC DENTISTRY PLLC
Active
Other names
Fort Worth Children's Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW M JAMISON D.D.S (DOCTOR/OWNER)
(817) 569-6633
Entity
Organization
Contact information
Practice address
5521 BELLAIRE DR S, SUITE 210, FORT WORTH, TX 76109-8838
(817) 569-6633
(817) 569-6636
Mailing address
5521 BELLAIRE DR S, SUITE 210, FORT WORTH, TX 76109-8838
(817) 569-6633
(817) 569-6636
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
21557
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0913279-01
—
TX
Enumeration date
05/19/2015
Last updated
05/21/2015
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