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General NPI Number Information
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NPI Number | 1366072993
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Entity Type | Organization
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Legal Business Name | S&A DENTAL PARTNERS PLLC
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 1721 CIMARRON TRL STE 2
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City | HURST
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State | TX
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Zip | 76054-3400
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Country | US
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Telephone | 817-268-1112
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Fax | 817-330-8182
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Provider Business Mailing Address
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Address Line | 1721 CIMARRON TRL STE 2
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City | HURST
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State | TX
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Zip | 76054-3400
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Country | US
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Telephone | 817-268-1112
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Fax | 817-330-8182
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | PATTY HAYES
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Credential |
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Telephone | 817-268-1112
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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 |
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License Number State |
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