Individual
DR. DARRELL KELLUS PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6737 BRENTWOOD STAIR RD, #220, FORT WORTH, TX 76112-3348
(817) 451-2323
(817) 451-1336
Mailing address
6737 BRENTWOOD STAIR RD, #220, FORT WORTH, TX 76112-3348
(817) 451-2323
(817) 451-1336
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13388
TX
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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