MEDICARE: HARVEEN DHILLON HANS 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	19297	TX

General Provider Information

NPI Number	:	1215295175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARVEEN DHILLON HANS DDS

Provider Business Mailing Address
First Line	:	5428 BASSWOOD BLVD.
Second Line	:
City	:	FT. WORTH
State	:	TX
Zip	:	76137-4400
Country	:	US
Telephone Number	:	817-788-7700
Fax Number	:	817-281-0055

Provider Business Practice Location Address
First Line	:	5428 BASSWOOD BLVD.
Second Line	:
City	:	FT. WORTH
State	:	TX
Zip	:	76137-4400
Country	:	US
Telephone Number	:	817-788-7700
Fax Number	:	817-281-0055

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

Provider Enumeration Date	:	04/30/2012
Last Update Date	:	04/30/2012

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Directions to “ HARVEEN DHILLON HANS DDS” Practice Location

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