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Contact Information

HWY 30 DENTAL CLINIC P A
1204 WOODHAVEN BLVD
FORT WORTH, TX76112
 Phone: 817-654-9760
 Fax: 817-451-8389
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for HWY 30 DENTAL CLINIC P A

NPI Number 1083836217
LBN Legal business name HWY 30 DENTAL CLINIC P A
Authorized official KEVIN AFKAMI - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/03/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
TX License # 20467
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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