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General NPI Number Information
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NPI Number | 1285993477
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Entity Type | Organization
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Legal Business Name | LEGACY DENTAL OF MESQUITE PLLC
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 9208-B E. R.L. THORTON EXPRESSWAY #209-B
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 832-725-9895
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Fax |
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Provider Business Mailing Address
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Address Line | 9208-B E. R.L. THORTON EXPRESSWAY #209-B
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 832-725-9895
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SOHAIL SALEEM DAR
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Credential | DDS
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Telephone | 832-725-9895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25393
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25391
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License Number State | TX
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