Provider Demographics
NPI:1629338793
Name:TOWN NORTH DENTAL, P.A.
Entity Type:Organization
Organization Name:TOWN NORTH DENTAL, P.A.
Other - Org Name:BEAR CREEK FAMILY DENTIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAFEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-883-4285
Mailing Address - Street 1:532 W RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-5738
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:532 W RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-5738
Practice Address - Country:US
Practice Address - Phone:214-420-7008
Practice Address - Fax:214-420-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty