MEDICARE: DR. PARTHA MUKHERJI DDS

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	122300000X	Dentist	20850	TX

General Provider Information

NPI Number	:	1851480602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARTHA MUKHERJI DDS

Provider Business Mailing Address
First Line	:	7551 OAKMONT BLVD.
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132
Country	:	US
Telephone Number	:	817-292-9348
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 RED HAWK CT
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4106
Country	:	US
Telephone Number	:	817-294-8092
Fax Number	:	817-294-8692

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/18/2022

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