Provider Demographics
NPI:1659717189
Name:ADVANCE COMPREHENSIVE DENTAL CARE PA
Entity Type:Organization
Organization Name:ADVANCE COMPREHENSIVE DENTAL CARE PA
Other - Org Name:SLEEP AND SNORING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:AKKAD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:682-999-8452
Mailing Address - Street 1:4515 MATLOCK RD STE 117
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-5663
Mailing Address - Country:US
Mailing Address - Phone:855-847-3311
Mailing Address - Fax:817-717-6311
Practice Address - Street 1:4515 MATLOCK RD STE 117
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-5663
Practice Address - Country:US
Practice Address - Phone:855-847-3311
Practice Address - Fax:817-717-6311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
TX24010332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6801110001Medicare NSC