Provider Demographics
NPI:1245615822
Name:ENAMEL DENTAL PLLC
Entity Type:Organization
Organization Name:ENAMEL DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALU
Authorized Official - Middle Name:
Authorized Official - Last Name:PALHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-417-8301
Mailing Address - Street 1:9052 GUAVA CT
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4231
Mailing Address - Country:US
Mailing Address - Phone:214-417-8301
Mailing Address - Fax:
Practice Address - Street 1:8701 CYPRESS WATERS BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:214-417-8301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty