Provider Demographics
NPI:1326767682
Name:DESAI DENTAL PC
Entity Type:Organization
Organization Name:DESAI DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-773-0886
Mailing Address - Street 1:4913 RUFE SNOW DR STE 104
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7856
Mailing Address - Country:US
Mailing Address - Phone:817-656-2945
Mailing Address - Fax:
Practice Address - Street 1:4913 RUFE SNOW DR STE 104
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7856
Practice Address - Country:US
Practice Address - Phone:817-656-2945
Practice Address - Fax:817-656-1695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty