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General NPI Number Information
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NPI Number | 1770977167
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Entity Type | Organization
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Legal Business Name | DBK GROUP PLLC
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 1560 E. DEBBIE LANE SUITE 108
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City | MANSFIELD
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State | TX
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Zip | 76063
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Country | US
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Telephone | 817-488-2120
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Fax |
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Provider Business Mailing Address
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Address Line | 6207 COLLEYVILLE BLVD #150
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City | COLLEYVILLE
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State | TX
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Zip | 76034-8015
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Country | US
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Telephone | 817-488-2021
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAMERON HAMIDI
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Credential | DDS
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Telephone | 614-598-2078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 27324
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License Number State | TX
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