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General NPI Number Information
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NPI Number | 1831461953
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Entity Type | Organization
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Legal Business Name | ALL AMERICAN DENTAL PA
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 5910 BABCOCK RD SUITE 205
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City | SAN ANTONIO
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State | TX
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Zip | 78240-2481
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Country | US
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Telephone | 210-461-8107
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Fax | 210-521-4785
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Provider Business Mailing Address
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Address Line | 5910 BABCOCK RD SUITE 205
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City | SAN ANTONIO
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State | TX
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Zip | 78240-2481
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Country | US
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Telephone | 210-461-8107
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Fax | 210-521-4785
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Authorized Official
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Title or Position | DENTIST
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Name | DR. BASSAM ABAZID
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Credential | DDS
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Telephone | 210-461-8107
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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 | 26095
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License Number State | TX
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