MEDICARE: DAVID DEWINN FYFFE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	13,871	TX

General Provider Information

NPI Number	:	1104177542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DEWINN FYFFE DDS

Provider Business Mailing Address
First Line	:	11411 E NORTHWEST HWY
Second Line	:	SUITE 101
City	:	DALLAS
State	:	TX
Zip	:	75218-1428
Country	:	US
Telephone Number	:	214-340-1776
Fax Number	:	214-340-1676

Provider Business Practice Location Address
First Line	:	11411 E NORTHWEST HWY
Second Line	:	SUITE 101
City	:	DALLAS
State	:	TX
Zip	:	75218-1428
Country	:	US
Telephone Number	:	214-340-1776
Fax Number	:	214-340-1676

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2012
Last Update Date	:	09/25/2012

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Directions to “ DAVID DEWINN FYFFE DDS” Practice Location

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