Provider Demographics
NPI:1821866088
Name:OAK CLIFF DENTAL CARE PC
Entity Type:Organization
Organization Name:OAK CLIFF DENTAL CARE PC
Other - Org Name:OAK CLIFF DENTAL CARE PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SKEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-888-0091
Mailing Address - Street 1:790 W EXCHANGE PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-7009
Mailing Address - Country:US
Mailing Address - Phone:469-888-0091
Mailing Address - Fax:
Practice Address - Street 1:3606 MARVIN D LOVE FWY STE B
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-4400
Practice Address - Country:US
Practice Address - Phone:469-888-0091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty