Provider Demographics
NPI:1023369063
Name:IDEAL DENTAL OF CORINTH, PLLC
Entity Type:Organization
Organization Name:IDEAL DENTAL OF CORINTH, PLLC
Other - Org Name:CORNERSTONE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SULMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-321-2088
Mailing Address - Street 1:4020 FM 2181
Mailing Address - Street 2:
Mailing Address - City:HICKORY CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:75065-7526
Mailing Address - Country:US
Mailing Address - Phone:940-321-2088
Mailing Address - Fax:
Practice Address - Street 1:4020 FM 2181
Practice Address - Street 2:
Practice Address - City:HICKORY CREEK
Practice Address - State:TX
Practice Address - Zip Code:75065-7526
Practice Address - Country:US
Practice Address - Phone:940-321-2088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty