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204 S Nursery Rd Ste 170 Irving TX 75060-3184 | |
| (214) 493-1216 | |
| (214) 292-8661 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 204 S Nursery Rd Ste 170, Irving, Texas |
| Authorized Official Name and Position | Nina Abtahi (MANGER) |
| Authorized Official Contact | 2144931216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
519 N Cedar Ridge Dr Ste 101 Duncanville TX 75116-3183 Ph: (214) 493-1216 | 204 S Nursery Rd Ste 170 Irving TX 75060-3184 Ph: (214) 493-1216 |
| NPI Number | 1679084495 |
|---|---|
| Provider Enumeration Date | 10/19/2017 |
| Last Update Date | 11/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679084495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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