Provider Demographics
NPI:1457034241
Name:MECCA DENTAL PLLC
Entity type:Organization
Organization Name:MECCA DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SULMAAN
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:FAROOQUI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-725-4657
Mailing Address - Street 1:4840 RABBIT TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8333
Mailing Address - Country:US
Mailing Address - Phone:210-725-4657
Mailing Address - Fax:
Practice Address - Street 1:12955 MAIN STREET
Practice Address - Street 2:SUITE #100
Practice Address - City:FRISO
Practice Address - State:TX
Practice Address - Zip Code:75035
Practice Address - Country:US
Practice Address - Phone:469-920-8858
Practice Address - Fax:469-903-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty