MEDICARE: CALM DENTISTRY ARLINGTON PLLC

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	14150	TX

General Provider Information

NPI Number	:	1730639428
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALM DENTISTRY ARLINGTON PLLC

Provider Business Mailing Address
First Line	:	2011 W BARDIN RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1654
Country	:	US
Telephone Number	:	817-557-0025
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 W BARDIN RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1654
Country	:	US
Telephone Number	:	817-557-0025
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHEILA BIRTH
Credential	:	DDS, MS
Telephone Number	:	817-557-0025

Provider Enumeration Date	:	10/06/2016
Last Update Date	:	10/06/2016

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