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General NPI Number Information
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NPI Number | 1104262823
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Entity Type | Individual
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Provider Name | AMY N BENDER DDS
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Gender | Female
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 2925 OAK PARK CIR STE 200
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City | FORT WORTH
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State | TX
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Zip | 76109-1867
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Country | US
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Telephone | 817-207-9700
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Fax | 817-920-9307
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Provider Business Mailing Address
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Address Line | 2925 OAK PARK CIR STE 200
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City | FORT WORTH
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State | TX
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Zip | 76109-1867
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Country | US
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Telephone | 817-207-9700
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Fax | 817-920-9307
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 19331
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License Number State | TX
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