Provider Demographics
NPI:1689013096
Name:SMILE PERCISION DENTAL GROUP, PC
Entity Type:Organization
Organization Name:SMILE PERCISION DENTAL GROUP, PC
Other - Org Name:P.A. DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-383-5511
Mailing Address - Street 1:820 S ALMA DR STE 140
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3813
Mailing Address - Country:US
Mailing Address - Phone:214-383-5511
Mailing Address - Fax:
Practice Address - Street 1:820 S ALMA DR STE 140
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3813
Practice Address - Country:US
Practice Address - Phone:214-383-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty