Healthcare Provider Details
I. General information
NPI: 1457437295
Provider Name (Legal Business Name): NETWORK PROVIDER ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2006
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3330 MATLOCK RD. SUITE 100
ARLINGTON TX
76015-2925
US
IV. Provider business mailing address
PO BOX 860036
MINNEAPOLIS MN
55486-0036
US
V. Phone/Fax
- Phone: 817-419-9700
- Fax: 216-584-1415
- Phone: 817-419-9700
- Fax: 216-584-1415
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0700X |
| Taxonomy | Prosthodontics |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
DAVID
A.F.
ANDERSON
Title or Position: DENTIST/OWNER
Credential: DDS, MAGD
Phone: 817-419-9700