MEDICARE: AIR DENTAL P.A

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

General Provider Information

NPI Number	:	1831415041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIR DENTAL P.A

Provider Business Mailing Address
First Line	:	6401 NEW YORK AVE
Second Line	:	155
City	:	ARLINGTON
State	:	TX
Zip	:	76018-3166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6401 NEW YORK AVE
Second Line	:	155
City	:	ARLINGTON
State	:	TX
Zip	:	76018-3166
Country	:	US
Telephone Number	:	817-472-9300
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	CARINA TRAN
Credential	:
Telephone Number	:	817-472-9300

Provider Enumeration Date	:	04/13/2010
Last Update Date	:	04/13/2010

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Directions to “AIR DENTAL P.A ” Practice Location

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