Provider Demographics
NPI:1588250906
Name:AIM SP DENTAL PLLC
Entity type:Organization
Organization Name:AIM SP DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-215-9663
Mailing Address - Street 1:14500 SAN PEDRO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4354
Mailing Address - Country:US
Mailing Address - Phone:210-494-7300
Mailing Address - Fax:210-494-6842
Practice Address - Street 1:14500 SAN PEDRO AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4354
Practice Address - Country:US
Practice Address - Phone:210-494-7300
Practice Address - Fax:210-494-6842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental