MEDICARE: DAVID D. FYFFE, DDS PC

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	13871	TX

General Provider Information

NPI Number	:	1851491542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID D. FYFFE, DDS PC

Provider Business Mailing Address
First Line	:	11411 E NORTHWEST HWY
Second Line	:	SUITE 101
City	:	DALLAS
State	:	TX
Zip	:	75218-1428
Country	:	US
Telephone Number	:	214-340-1776
Fax Number	:	214-340-1676

Provider Business Practice Location Address
First Line	:	11411 E NORTHWEST HWY
Second Line	:	SUITE 101
City	:	DALLAS
State	:	TX
Zip	:	75218-1428
Country	:	US
Telephone Number	:	214-340-1776
Fax Number	:	214-340-1676

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID D. FYFFE
Credential	:	DDS
Telephone Number	:	214-340-1776

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	03/06/2012

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