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General NPI Number Information
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NPI Number | 1659717189
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Entity Type | Organization
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Legal Business Name | ADVANCE COMPREHENSIVE DENTAL CARE PA
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Dates
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Enumeration Date | 05/10/2013
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 4515 MATLOCK RD STE 117
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City | ARLINGTON
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State | TX
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Zip | 76018-5663
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Country | US
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Telephone | 855-847-3311
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Fax | 817-717-6311
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Provider Business Mailing Address
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Address Line | 4515 MATLOCK RD STE 117
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City | ARLINGTON
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State | TX
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Zip | 76018-5663
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Country | US
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Telephone | 855-847-3311
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Fax | 817-717-6311
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SALEM AKKAD
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Credential | DDS, MS
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Telephone | 682-999-8452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 24010
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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