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1689911349
DARRELL KELLUS PRUITT
FORT WORTH, TX
NPI
1689911349
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: TX 13388)
Enumeration Date
2013-01-14
Last Update Date
2013-01-14
Business Address
Dr. DARRELL KELLUS PRUITT DDS
6737 BRENTWOOD STAIR RD #220
FORT WORTH, TX 76112-3348
Phone number: 817-451-2323
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Mailing Address
Dr. DARRELL KELLUS PRUITT DDS
6737 BRENTWOOD STAIR RD #220
FORT WORTH, TX 76112-3348
Phone number: 817-451-2323
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