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General NPI Number Information
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NPI Number | 1417007543
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Entity Type | Organization
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Legal Business Name | SUNSET OAKS DENTAL P.A.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17194 PRESTON RD STE 212
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City | DALLAS
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State | TX
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Zip | 75248-1225
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Country | US
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Telephone | 972-248-6684
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Fax | 972-250-0120
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Provider Business Mailing Address
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Address Line | 17194 PRESTON RD STE 212
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City | DALLAS
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State | TX
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Zip | 75248-1225
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Country | US
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Telephone | 972-248-6684
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Fax | 972-250-0120
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Authorized Official
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Title or Position | DENTIST
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Name | DR. BITA KOUSHYAR KAMALI
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Credential | D.D.S.
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Telephone | 972-248-6684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 20099
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License Number State | TX
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