Provider Demographics
NPI:1497363279
Name:AFFORDABLE DENTIST NEAR ME LANCASTER,PLLC
Entity Type:Organization
Organization Name:AFFORDABLE DENTIST NEAR ME LANCASTER,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAQIB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-656-1215
Mailing Address - Street 1:5416 BASSWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-4400
Mailing Address - Country:US
Mailing Address - Phone:817-656-1215
Mailing Address - Fax:
Practice Address - Street 1:1370 W BELT LINE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2110
Practice Address - Country:US
Practice Address - Phone:817-656-1215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty