MEDICARE: OV CARTWRIGHT DOS INC

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	11790	TX

General Provider Information

NPI Number	:	1720085418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OV CARTWRIGHT DOS INC

Provider Business Mailing Address
First Line	:	117 N BELT LINE RD
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-5800
Country	:	US
Telephone Number	:	972-262-1395
Fax Number	:	972-262-1397

Provider Business Practice Location Address
First Line	:	117 N BELT LINE RD
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-5800
Country	:	US
Telephone Number	:	972-262-1395
Fax Number	:	972-262-1397

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHRIS S CARTWRIGHT
Credential	:	DDS
Telephone Number	:	972-262-1395

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2020

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