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General NPI Number Information
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NPI Number | 1215201041
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Entity Type | Organization
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Legal Business Name | ENDODONTIC ASSOCIATES OF TARRANT COUNTY, PA
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Dates
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Enumeration Date | 02/24/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 2201 MARTIN DR SUITE 100
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City | BEDFORD
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State | TX
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Zip | 76021-5997
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Country | US
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Telephone | 817-283-5544
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Fax | 817-283-5873
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Provider Business Mailing Address
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Address Line | 2201 MARTIN DR SUITE 100
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City | BEDFORD
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State | TX
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Zip | 76021-5997
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Country | US
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Telephone | 817-283-5544
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Fax | 817-283-5873
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Authorized Official
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Title or Position | OWNER
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Name | DR. YOGESH T. PATAL
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Credential | DDS
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Telephone | 214-342-0425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 20123
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License Number State | TX
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