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General NPI Number Information
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NPI Number | 1487966552
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Entity Type | Organization
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Legal Business Name | IDEAL DENTAL OF PLANO
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 4949 HEDGCOXE RD SUITE 160
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City | PLANO
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State | TX
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Zip | 75024-3898
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Country | US
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Telephone | 214-387-8800
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Fax | 214-387-8825
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Provider Business Mailing Address
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Address Line | 4949 HEDGCOXE RD SUITE 160
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City | PLANO
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State | TX
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Zip | 75024-3898
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Country | US
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Telephone | 214-387-8800
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Fax | 214-387-8825
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Authorized Official
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Title or Position | OWNER
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Name | DR. RODNEY N ALLES
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Credential | DDS
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Telephone | 214-387-8800
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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 | 22618
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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 | 22290
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License Number State | TX
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