Cc Dental PC

NPI #1851569297 in Ft Worth, Texas

Provider Information

NPI Number: 1851569297
Entity Type: Organization
Organization Name: Cc Dental PC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Feb 20, 2008
Last Updated: Feb 20, 2008

Practice Location

Address: 1051 HASKELL ST
City: Ft Worth
State: Texas
ZIP Code: 76107
Phone: (817) 737-8731

Authorized Official

Name: DR. TY DOUGLAS SHAFER, DDS
Title: OWNER
Phone: (817) 737-8731

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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