MEDICARE: SHOWTIME FAMILY DENTAL

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
1	1223G0001X	General Practice Dentistry	22677	TX

General Provider Information

NPI Number	:	1790926806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHOWTIME FAMILY DENTAL

Provider Business Mailing Address
First Line	:	3401 ALTAMESA BLVD
Second Line	:	SUITE 128
City	:	FORT WORTH
State	:	TX
Zip	:	76133-8741
Country	:	US
Telephone Number	:	817-361-8111
Fax Number	:	817-361-8113

Provider Business Practice Location Address
First Line	:	3401 ALTAMESA BLVD
Second Line	:	SUITE 128
City	:	FORT WORTH
State	:	TX
Zip	:	76133-8741
Country	:	US
Telephone Number	:	817-361-8111
Fax Number	:	817-361-8113

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. SONIA DENISE SMITH
Credential	:	D.D.S
Telephone Number	:	817-723-7141

Provider Enumeration Date	:	03/19/2009
Last Update Date	:	03/23/2016

Similar Medicare Providers

1104926856 — BERNARD FRANCOIS CHRISPHONTE RRT
Practice Location Address:

6862 HOULTON CIR
LAKE WORTH, FL
33467-8741

Practice Phone: 561-304-0598
Practice Fax:

1841381449 — JACQUELINE ELIZABETH HURTADO RRT
Practice Location Address:

6862 HOULTON CIR
LAKE WORTH, FL
33467-8741

Practice Phone: 561-304-0598
Practice Fax:

1043697949 — TANYA FARRIS-STEWARD LMT
Practice Location Address:

6898 HOULTON CIR
LAKE WORTH, FL
33467-8741

Practice Phone: 561-870-0980
Practice Fax:

1326556473 — YANICK BELIZAIRE FNP
Practice Location Address:

6868 HOULTON CIR
LAKE WORTH, FL
33467-8741

Practice Phone: 786-303-1191
Practice Fax: 786-303-1191

1427723659 — CAYLA LYNN LARSON DPT
Practice Location Address:

7410 MCCART AVE STE 108
FORT WORTH, TX
76133-7427

Practice Phone: 682-350-4318
Practice Fax:

1386647634 — ADVANCED NEUROLOGICAL SERVICES
Practice Location Address:

2755 ALTA MESA BLVD
FORT WORTH, TX
76133-5803

Practice Phone: 817-292-2208
Practice Fax: 817-292-8021

Directions to “SHOWTIME FAMILY DENTAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.