Organization
BIRTH STEWART ORAL SURGERY FT WORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES STEWART DDS (ORTHODONTIST)
(817) 370-0268
Entity
Organization
Contact information
Practice address
3060 SYCAMORE SCHOOL RD, FORT WORTH, TX 76133-7771
(817) 370-0268
(817) 263-9217
Mailing address
PO BOX 330874, FORT WORTH, TX 76163-0874
(817) 370-0268
(817) 263-9217
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
11736
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
19486
TX
Other
Enumeration date
08/06/2013
Last updated
11/08/2013
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