MEDICARE: DR. CATHERINE CHAUMONT 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	1223G0001X	General Practice Dentistry	22211	TX

General Provider Information

NPI Number	:	1972687259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE CHAUMONT DDS

Provider Business Mailing Address
First Line	:	3924 PELHAM ROAD
Second Line	:
City	:	FT. WORTH
State	:	TX
Zip	:	76116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 5TH AVE STE G
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2903
Country	:	US
Telephone Number	:	817-332-9700
Fax Number	:

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	05/02/2008

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