MEDICARE: HEDAYAT ANBAR D.D.S.. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	18274	TX

General Provider Information

NPI Number	:	1972782100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEDAYAT ANBAR D.D.S.. PA

Provider Business Mailing Address
First Line	:	4520 FRANKFORD RD STE 900
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-6859
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4520 FRANKFORD RD STE 900
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-6859
Country	:	US
Telephone Number	:	972-818-5551
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HEDAYAT ANBAR
Credential	:
Telephone Number	:	972-818-5551

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	06/24/2008

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