Provider Demographics
NPI:1245816230
Name:SUNNYVALE DENTAL GROUP PLLC
Entity type:Organization
Organization Name:SUNNYVALE DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAUMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-302-2486
Mailing Address - Street 1:270 S COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-4641
Mailing Address - Country:US
Mailing Address - Phone:214-302-2486
Mailing Address - Fax:
Practice Address - Street 1:270 S COLLINS RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4641
Practice Address - Country:US
Practice Address - Phone:214-302-2486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty