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NPI Code Detail

MEDICARE: R & R 15 15, LLC

MEDICARE: R & R 15 15, LLC
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 Dentistry

General Provider Information

NPI Number : 1801185608
Entity Type Code : Organization
Provider Name (Legal Business Name) : R & R 15 15, LLC
Provider Business Mailing Address
First Line : 12900 PRESTON RD STE 804
Second Line :
City : DALLAS
State : TX
Zip : 75230-6314
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6443 MCCART AVE
Second Line :
City : FT WORTH
State : TX
Zip : 76133-4702
Country : US
Telephone Number : 817-984-7460
Fax Number :
Authorized Official
Title or Position : OWNER/DENTIST
Name : REZA ZAMANIAN
Credential :
Telephone Number : 469-323-6297
Provider Enumeration Date : 04/01/2011
Last Update Date : 04/01/2011

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Directions to “R & R 15 15, LLC ” Practice Location

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