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General NPI Number Information
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NPI Number | 1144975798
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Entity Type | Organization
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Legal Business Name | DENTAL AESTHETIC
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Dates
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Enumeration Date | 02/12/2022
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Last Update Date | 02/12/2022
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Provider Practice Location Address
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Address Line | 10220 W BELL RD STE 104
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City | SUN CITY
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State | AZ
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Zip | 85351-1179
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Country | US
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Telephone | 623-300-5432
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Fax |
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Provider Business Mailing Address
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Address Line | 4950 W TONTO RD
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City | GLENDALE
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State | AZ
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Zip | 85308-9222
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Country | US
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Telephone | 914-621-6878
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. ABDULLAH AHMAD
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Credential | DMD
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Telephone | 914-621-6878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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