| Ideal Dental Of Waterside Pllc | |
|
5925 Convair Dr Ste F505 Ft Worth TX 76109-1275 | |
| (817) 778-0418 | |
| Not Available |
| Full Name | Ideal Dental Of Waterside Pllc |
|---|---|
| Speciality | Dentist |
| Location | 5925 Convair Dr Ste F505, Ft Worth, Texas |
| Authorized Official Name and Position | Sulman Ahmed (CEO) |
| Authorized Official Contact | 9723318079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Dental Of Waterside Pllc Po Box 840925 Dallas TX 75284-0925 Ph: () - | Ideal Dental Of Waterside Pllc 5925 Convair Dr Ste F505 Ft Worth TX 76109-1275 Ph: (817) 778-0418 |
| NPI Number | 1629580394 |
|---|---|
| Provider Enumeration Date | 11/02/2017 |
| Last Update Date | 05/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629580394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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