MEDICARE: DR. STEVEN KEITH BRITAIN 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	1223P0300X	Periodontics	19028	TX

General Provider Information

NPI Number	:	1437207552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN KEITH BRITAIN DDS

Provider Business Mailing Address
First Line	:	4900 OVERTON RIDGE BLVD
Second Line	:	SUITE 213
City	:	FORT WORTH
State	:	TX
Zip	:	76132-1940
Country	:	US
Telephone Number	:	817-423-0138
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 OVERTON RIDGE BLVD
Second Line	:	SUITE 213
City	:	FORT WORTH
State	:	TX
Zip	:	76132-1940
Country	:	US
Telephone Number	:	817-423-0138
Fax Number	:

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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