Provider Demographics
NPI:1164935060
Name:ENSURE DENTAL CARE PLLC
Entity Type:Organization
Organization Name:ENSURE DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RASHI
Authorized Official - Middle Name:VINAYAK
Authorized Official - Last Name:MUTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-710-1812
Mailing Address - Street 1:9519 VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5065
Mailing Address - Country:US
Mailing Address - Phone:630-780-7948
Mailing Address - Fax:
Practice Address - Street 1:520 S SAGINAW BLVD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1906
Practice Address - Country:US
Practice Address - Phone:682-710-1812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29858261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental