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NPI Code Detail

MEDICARE: ACORN DENTAL OF KELLER

MEDICARE: ACORN DENTAL OF KELLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry9091TX

General Provider Information

NPI Number : 1548562341
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACORN DENTAL OF KELLER
Provider Business Mailing Address
First Line : 5334 N TARRANT PKWY
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-6293
Country : US
Telephone Number : 817-514-6253
Fax Number : 817-514-6230
Provider Business Practice Location Address
First Line : 5334 N TARRANT PKWY
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-6293
Country : US
Telephone Number : 817-514-6253
Fax Number : 817-514-6230
Authorized Official
Title or Position : OWNER
Name : DR. JESSE N SCHROEDER
Credential : DDS,MS
Telephone Number : 817-514-6253
Provider Enumeration Date : 11/30/2010
Last Update Date : 11/30/2010

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Directions to “ACORN DENTAL OF KELLER ” Practice Location

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