Provider Demographics
NPI:1245589571
Name:ALL ABOUT DENTAL. LLC
Entity Type:Organization
Organization Name:ALL ABOUT DENTAL. LLC
Other - Org Name:PRESTIGE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHKOULI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-649-3101
Mailing Address - Street 1:19665 SW TV HWY
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97006-2352
Mailing Address - Country:US
Mailing Address - Phone:503-649-3101
Mailing Address - Fax:503-259-1330
Practice Address - Street 1:19665 SW TV HWY
Practice Address - Street 2:SUITE A-1
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97006-2352
Practice Address - Country:US
Practice Address - Phone:503-649-3101
Practice Address - Fax:503-259-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty