Provider Demographics
NPI:1477976223
Name:IDEAL DENTAL OF GARLAND PLLC
Entity Type:Organization
Organization Name:IDEAL DENTAL OF GARLAND PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-368-9889
Mailing Address - Street 1:3121 N GEORGE BUSH FWY
Mailing Address - Street 2:SUITE 113
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2752
Mailing Address - Country:US
Mailing Address - Phone:469-368-9889
Mailing Address - Fax:
Practice Address - Street 1:3121 N GEORGE BUSH FWY
Practice Address - Street 2:SUITE 113
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2752
Practice Address - Country:US
Practice Address - Phone:469-368-9889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty