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General NPI Number Information
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NPI Number | 1902977465
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Entity Type | Individual
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Provider Name | GEMMA DALTON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2307 CENTRAL DR
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City | BEDFORD
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State | TX
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Zip | 76021-7748
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Country | US
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Telephone | 817-571-1667
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Fax | 817-571-1669
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Provider Business Mailing Address
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Address Line | 2307 CENTRAL DR
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City | BEDFORD
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State | TX
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Zip | 76021-7748
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Country | US
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Telephone | 817-571-1667
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Fax | 817-571-1669
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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 | 20360
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License Number State | TX
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