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General NPI Number Information
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NPI Number | 1982992723
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Entity Type | Individual
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Provider Name | LEVY T DO D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1560 E DEBBIE LN STE 108
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City | MANSFIELD
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State | TX
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Zip | 76063-8575
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Country | US
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Telephone | 817-453-8520
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Fax |
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Provider Business Mailing Address
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Address Line | 1560 E DEBBIE LN STE 108
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City | MANSFIELD
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State | TX
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Zip | 76063-8575
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Country | US
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Telephone | 817-453-8520
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Fax | 817-453-8522
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28984
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License Number State | TX
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