Provider Demographics
NPI:1083866180
Name:DENTAL TIME
Entity Type:Organization
Organization Name:DENTAL TIME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHABBIR
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PA
Authorized Official - Phone:281-679-8463
Mailing Address - Street 1:12579 RICHMOND AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2552
Mailing Address - Country:US
Mailing Address - Phone:281-679-8463
Mailing Address - Fax:
Practice Address - Street 1:12579 RICHMOND AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2552
Practice Address - Country:US
Practice Address - Phone:281-679-8463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19234261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental