Provider Demographics
NPI:1720118318
Name:AYAS, TAREK (DDS, PC)
Entity Type:Individual
Prefix:MR
First Name:TAREK
Middle Name:
Last Name:AYAS
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 S COOPER ST STE 140
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3477
Mailing Address - Country:US
Mailing Address - Phone:817-468-8839
Mailing Address - Fax:
Practice Address - Street 1:3620 S COOPER ST STE 140
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3477
Practice Address - Country:US
Practice Address - Phone:817-468-8839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17528122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist