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NPI Code Detail

MEDICARE: THOMAS YOUNG DDS

MEDICARE:   THOMAS  YOUNG  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 Dentistry23321TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123321OTHERTXDENTIST

General Provider Information

NPI Number : 1427249887
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS YOUNG DDS
Provider Business Mailing Address
First Line : 3529 HERITAGE TRACE PKWY STE 171
Second Line :
City : FORT WORTH
State : TX
Zip : 76244-4971
Country : US
Telephone Number : 817-741-4567
Fax Number : 817-741-4576
Provider Business Practice Location Address
First Line : 3529 HERITAGE TRACE PKWY
Second Line : SUITE 171
City : FORT WORTH
State : TX
Zip : 76244-4970
Country : US
Telephone Number : 817-741-4567
Fax Number : 817-741-4576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2007
Last Update Date : 08/31/2011

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Directions to “ THOMAS YOUNG DDS” Practice Location

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