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General NPI Number Information
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NPI Number | 1790966703
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Entity Type | Organization
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Legal Business Name | SINA DENTAL
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 7912 SPRING VALLEY RD
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City | DALLAS
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State | TX
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Zip | 75254-2844
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Country | US
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Telephone | 972-404-0000
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Fax | 972-404-0005
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Provider Business Mailing Address
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Address Line | 7912 SPRING VALLEY RD
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City | DALLAS
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State | TX
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Zip | 75254-2844
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Country | US
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Telephone | 972-404-0000
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Fax | 972-404-0005
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Authorized Official
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Title or Position | CEO
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Name | DR. AHMAD HAMIDFAR
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Credential | DDS
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Telephone | 972-693-8080
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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 | 21646
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License Number State | TX
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