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Organization

DR. SHEILA BIRTH-ORTHODONTICS-KELLER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHEILA BIRTH D. D.S., M.S. (ORTHODONTIST)
(817) 348-0910
Entity
Organization

Contact information

Practice address
4420 HERITAGE TRACE PKWY STE 300, FORT WORTH, TX 76244-8904
(817) 348-0910
Mailing address
4420 HERITAGE TRACE PKWY STE 300, FORT WORTH, TX 76244-8904
(817) 348-0910

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
14150
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
172836201
TX
Enumeration date
02/13/2007
Last updated
03/28/2014
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