Provider Demographics
NPI:1275936734
Name:IDEAL DENTAL OF PRESTON CREEK PLLC
Entity Type:Organization
Organization Name:IDEAL DENTAL OF PRESTON CREEK PLLC
Other - Org Name:PLANO CENTER DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SULMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:972-377-5530
Mailing Address - Street 1:8404 PRESTON RD
Mailing Address - Street 2:STE 212
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3331
Mailing Address - Country:US
Mailing Address - Phone:972-377-5530
Mailing Address - Fax:
Practice Address - Street 1:8404 PRESTON RD
Practice Address - Street 2:STE 212
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3331
Practice Address - Country:US
Practice Address - Phone:972-377-5530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty