| Alassaf Dental Pllc | |
|
9716 Blue Mound Rd Fort Worth TX 76131-3301 | |
| (682) 444-6813 | |
| Not Available |
| Full Name | Alassaf Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 9716 Blue Mound Rd, Fort Worth, Texas |
| Authorized Official Name and Position | Omar Alassaf (PRESIDENT) |
| Authorized Official Contact | 6824446813 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alassaf Dental Pllc 5720 Mountain Stream Trl Fort Worth TX 76244-5165 Ph: (682) 444-6813 | Alassaf Dental Pllc 9716 Blue Mound Rd Fort Worth TX 76131-3301 Ph: (682) 444-6813 |
| NPI Number | 1790490837 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 01/23/2023 |
| Medicare PECOS PAC ID | 1456724210 |
|---|---|
| Medicare Enrollment ID | O20230227002594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790490837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Omar Alassaf |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1710470455 PECOS PAC ID: 2365815123 Enrollment ID: I20230227002694 |
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