MEDICARE: BARRETT L. BARTELL, D.D.S., PA

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	21613	TX

General Provider Information

NPI Number	:	1538249503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRETT L. BARTELL, D.D.S., PA

Provider Business Mailing Address
First Line	:	6013 WEDGWOOD DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-2770
Country	:	US
Telephone Number	:	817-346-6411
Fax Number	:	817-346-0463

Provider Business Practice Location Address
First Line	:	6013 WEDGWOOD DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-2770
Country	:	US
Telephone Number	:	817-346-6411
Fax Number	:	817-346-0463

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BARRETT L. BARTELL
Credential	:	D.D.S., PA
Telephone Number	:	817-346-6411

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	03/27/2014

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