Healthcare Provider Details

I. General information

NPI: 1669019782
Provider Name (Legal Business Name): RMS DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 EDWARDS RANCH RD STE 101
FORT WORTH TX
76109-4105
US

IV. Provider business mailing address

5656 EDWARDS RANCH RD STE 101
FORT WORTH TX
76109-4105
US

V. Phone/Fax

Practice location:
  • Phone: 817-731-9487
  • Fax:
Mailing address:
  • Phone: 817-731-9487
  • Fax: 817-731-2846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: RYAN SCHMIDGALL
Title or Position: MEMBER
Credential: DDS
Phone: 817-731-9487