Individual
DR. NICHOLAS AUSTEN TAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7451 N BEACH ST STE 140, FORT WORTH, TX 76137-5160
(817) 847-7001
Mailing address
7451 N BEACH ST STE 140, FORT WORTH, TX 76137-5160
(817) 847-7001
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
22DI02836900
NJ
1223P0221X
Pediatric Dentistry
Primary
38769
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2020
Last updated
07/25/2022
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