Provider Demographics
NPI:1831641653
Name:M DHOLARIYA DDS PLLC
Entity Type:Organization
Organization Name:M DHOLARIYA DDS PLLC
Other - Org Name:KYLE PARKWAY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:DHOLARIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-256-0105
Mailing Address - Street 1:4650 SOUTH FM 1626
Mailing Address - Street 2:SUITE 104
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640
Mailing Address - Country:US
Mailing Address - Phone:512-256-0105
Mailing Address - Fax:
Practice Address - Street 1:4650 SOUTH FM 1626
Practice Address - Street 2:SUITE 104
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640
Practice Address - Country:US
Practice Address - Phone:512-256-0105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX288771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty