MEDICARE: DR. LAUREN ELIZABETH GETZ 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	1223G0001X	General Practice Dentistry	37506	TX

General Provider Information

NPI Number	:	1295307734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN ELIZABETH GETZ DDS

Provider Business Mailing Address
First Line	:	2469 FOREST PARK BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-1731
Country	:	US
Telephone Number	:	817-924-6211
Fax Number	:	817-924-6212

Provider Business Practice Location Address
First Line	:	2469 FOREST PARK BLVD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76110-1731
Country	:	US
Telephone Number	:	817-924-6211
Fax Number	:	817-924-6212

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

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	07/14/2021

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