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NPI Code Detail

MEDICARE: DR. MITCHELL ALLEN CONDITT DDS

MEDICARE: DR. MITCHELL ALLEN CONDITT 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
11223G0001XGeneral Practice Dentistry14612TX

General Provider Information

NPI Number : 1184648982
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MITCHELL ALLEN CONDITT DDS
Provider Business Mailing Address
First Line : 451 UNIVERSITY DR STE 102
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-2130
Country : US
Telephone Number : 817-527-8500
Fax Number : 817-527-8512
Provider Business Practice Location Address
First Line : 451 UNIVERSITY DR STE 102
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-2130
Country : US
Telephone Number : 817-527-8500
Fax Number : 817-527-8512
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 05/14/2025

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Directions to “ DR. MITCHELL ALLEN CONDITT DDS” Practice Location

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