Provider Demographics
NPI:1831461953
Name:ALL AMERICAN DENTAL PA
Entity type:Organization
Organization Name:ALL AMERICAN DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BASSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABAZID
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-461-8107
Mailing Address - Street 1:5910 BABCOCK RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2481
Mailing Address - Country:US
Mailing Address - Phone:210-461-8107
Mailing Address - Fax:210-521-4785
Practice Address - Street 1:5910 BABCOCK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-2481
Practice Address - Country:US
Practice Address - Phone:210-461-8107
Practice Address - Fax:210-521-4785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26095122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty