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Organization

FUNDENTIST-NORTH

Active
Other names
Drs Hyde Bailey Miller PTR North
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES W. MILLER DDS, MS (OWNER)
(817) 478-2300
Entity
Organization

Contact information

Practice address
801 W. ROAD TO SIX FLAGS, SUITE 101, ARLINGTON, TX 76012
(817) 459-1313
(817) 549-8970
Mailing address
4220 LITTLE ROAD, ARLINGTON, TX 76016
(817) 478-2300
(817) 478-4904

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1223P0221X
Pediatric Dentistry
9223
TX
1223P0221X
Pediatric Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009668701
TX
Enumeration date
08/23/2006
Last updated
01/30/2023
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