Provider Demographics
NPI:1528837598
Name:ARLINGTON TX DENTAL PLLC
Entity type:Organization
Organization Name:ARLINGTON TX DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMALPREET
Authorized Official - Middle Name:
Authorized Official - Last Name:SHALLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-759-2152
Mailing Address - Street 1:13551 SPOKANE WAY
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-1334
Mailing Address - Country:US
Mailing Address - Phone:347-759-2152
Mailing Address - Fax:
Practice Address - Street 1:5616 SW GREEN OAKS BLVD STE A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1152
Practice Address - Country:US
Practice Address - Phone:817-572-3351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty