Provider Demographics
NPI:1336268861
Name:AFR DENTAL
Entity Type:Organization
Organization Name:AFR DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRONT DESK WORKER
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:VIKTOROVNA
Authorized Official - Last Name:SHULYAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-398-0020
Mailing Address - Street 1:5509 PLEASANT VALLEY DR
Mailing Address - Street 2:SUITE 90B
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-5248
Mailing Address - Country:US
Mailing Address - Phone:972-398-0020
Mailing Address - Fax:972-398-0021
Practice Address - Street 1:5509 PLEASANT VALLEY DR
Practice Address - Street 2:SUITE 90B
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-5248
Practice Address - Country:US
Practice Address - Phone:972-398-0020
Practice Address - Fax:972-398-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty