Provider Demographics
NPI:1598982951
Name:HOME TOWN DENTAL OF ARLINGTON PC
Entity Type:Organization
Organization Name:HOME TOWN DENTAL OF ARLINGTON PC
Other - Org Name:HOME TOWN DENTAL OF ARLINGTON PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MONJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:GURAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-528-6665
Mailing Address - Street 1:1030 W ARKANSAS LN
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6377
Mailing Address - Country:US
Mailing Address - Phone:817-543-2222
Mailing Address - Fax:817-543-2299
Practice Address - Street 1:1030 W ARKANSAS LN
Practice Address - Street 2:SUITE 210
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6377
Practice Address - Country:US
Practice Address - Phone:817-543-2222
Practice Address - Fax:817-543-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty