Provider Demographics
NPI:1215333240
Name:TEASLEY CENTER DENTAL PLLC
Entity type:Organization
Organization Name:TEASLEY CENTER DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SULMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:940-382-1199
Mailing Address - Street 1:5050 TEASLEY LN
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-3802
Mailing Address - Country:US
Mailing Address - Phone:940-382-1199
Mailing Address - Fax:
Practice Address - Street 1:5050 TEASLEY LN
Practice Address - Street 2:SUITE 110
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-3802
Practice Address - Country:US
Practice Address - Phone:940-382-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty