Provider Demographics
NPI:1093396749
Name:ASETHETICA DENTAL, PC
Entity Type:Organization
Organization Name:ASETHETICA DENTAL, PC
Other - Org Name:WYLIE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEKHYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATAGARLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-961-1744
Mailing Address - Street 1:5808 BAY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5210
Mailing Address - Country:US
Mailing Address - Phone:801-440-1488
Mailing Address - Fax:
Practice Address - Street 1:2014 N HIGHWAY 78 STE 150
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-6091
Practice Address - Country:US
Practice Address - Phone:801-440-1488
Practice Address - Fax:817-426-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental