CC DENTAL PC – NPI #1851569297
Clinic/Center

CC DENTAL PC is an AHC clinic located in FORT WORTH, TX. NPPES has assigned the NPI number 1851569297 to CC DENTAL PC on February 20, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CC DENTAL PC below.

NPI Profile for
CC DENTAL PC

NPI Number
1851569297
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CC DENTAL PC
Primary location
1051 HASKELL ST
FORT WORTH, TX 76107
Phone: (817) 737-8731 Fax:
Mailing address
PO BOX 93653
SOUTHLAKE, TX 76092-0115
Phone: (817) 737-8731 Fax: (817) 763-9342
Organization Subpart
No
Authorized Official
TY SHAFER
OWNER
Phone: (817) 737-8731
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.