Organization
CHILDREN'S DENTAL SERVICES OF TEXAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON A ZIMMERMAN DDS (OWNER)
(817) 731-8600
Entity
Organization
Contact information
Practice address
4545 BELLAIRE DR S STE 4, FORT WORTH, TX 76109-1811
(817) 731-8600
(817) 207-0719
Mailing address
PO BOX 55367, HURST, TX 76054-5367
(214) 533-8183
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
20465
TX
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210915901
—
TX
Enumeration date
03/29/2010
Last updated
11/02/2022
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