Organization · Type 2 NPI

Cook Childrens Physician Network

Pediatric Dentistry · Fort Worth, TX

NPI number 1841601291 Active

Practice location

2600 E Berry Street
Fort Worth, TX 76105-4750

Call (817) 347-4600 Map

Fax (817) 347-4639

Mailing address

PO Box 732669
Dallas, TX 75373-2669

Specialties and licenses

Taxonomy	Code	License
Pediatric Dentistry Primary	1223P0221X	None listed

Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

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NPI record

NPI: 1841601291
Entity type: Organization (Type 2)
Issued: May 19, 2014
Last updated: Jun 29, 2021
Status: Active
Subpart: Yes of Cook Childrens Physician Network

Other names

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Cook Children's Dental · doing business as
Cook Children's Dental · doing business as

Authorized official

Matthew V Dzurik, MD
President, CCPN
(682) 885-1416

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1841601291

Cook Childrens Physician Network's National Provider Identifier is 1841601291, issued on May 19, 2014. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Fort Worth, TX. The record was last updated on Jun 29, 2021.