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Individual

DR. SHEILA T BIRTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S. M.S.

Contact information

Practice address
5407 BASSWOOD BLVD STE 107, FORT WORTH, TX 76137-4499
(817) 348-0910
(817) 348-0422
Mailing address
5407 BASSWOOD BLVD STE 107, FORT WORTH, TX 76137-4499
(817) 348-0910
(817) 348-0422

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
07979621
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
091086103
TX
05
172836201
TX
Enumeration date
04/23/2007
Last updated
09/15/2011
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