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General NPI Number Information
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NPI Number | 1407555121
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Entity Type | Organization
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Legal Business Name | JASON S. DAABOUL DDS PA
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Dates
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Enumeration Date | 03/02/2023
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 2800 WILLIAM D. TATE AVENUE SUITE 200
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City | GRAPEVINE
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State | TX
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Zip | 76051
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Country | US
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Telephone | 817-488-7885
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Fax | 817-421-6176
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Provider Business Mailing Address
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Address Line | 2800 WILLIAM D. TATE AVENUE SUITE 200
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City | GRAPEVINE
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State | TX
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Zip | 76051
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Country | US
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Telephone | 817-488-7885
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Fax | 817-421-6176
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON SAAD-EDDINE DAABOUL
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Credential | DDS
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Telephone | 817-690-8088
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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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