Provider Demographics
NPI:1760257463
Name:US DENTAL LLC
Entity Type:Organization
Organization Name:US DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WAJDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSABIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:317-566-3300
Mailing Address - Street 1:14904 GREYHOUND CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1091
Mailing Address - Country:US
Mailing Address - Phone:317-566-3300
Mailing Address - Fax:317-566-3302
Practice Address - Street 1:14904 GREYHOUND CT
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1091
Practice Address - Country:US
Practice Address - Phone:317-566-3300
Practice Address - Fax:317-566-3302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty