Provider Demographics
NPI:1417669557
Name:AZTEC DENTAL PLLC
Entity Type:Organization
Organization Name:AZTEC DENTAL PLLC
Other - Org Name:AZTEC DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAAMEH
Authorized Official - Suffix:
Authorized Official - Credentials:PLLC
Authorized Official - Phone:361-480-0311
Mailing Address - Street 1:10338 S PADRE ISLAND DR # 2
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78418-4451
Mailing Address - Country:US
Mailing Address - Phone:361-480-0311
Mailing Address - Fax:
Practice Address - Street 1:10338 S PADRE ISLAND DR # 2
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-4451
Practice Address - Country:US
Practice Address - Phone:361-480-0311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty