Provider Demographics
NPI:1275257156
Name:ADVANCE DENTAL CARE OF TOLEDO
Entity Type:Organization
Organization Name:ADVANCE DENTAL CARE OF TOLEDO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MHD JALAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHAFFAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-474-9944
Mailing Address - Street 1:5859 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1421
Mailing Address - Country:US
Mailing Address - Phone:419-474-9944
Mailing Address - Fax:
Practice Address - Street 1:5859 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1421
Practice Address - Country:US
Practice Address - Phone:419-474-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty