Provider Demographics
NPI:1598594061
Name:DIZDAREVIC, ARNELA (DMD)
Entity type:Individual
Prefix:DR
First Name:ARNELA
Middle Name:
Last Name:DIZDAREVIC
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 BRANCHWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3787
Mailing Address - Country:US
Mailing Address - Phone:214-620-4960
Mailing Address - Fax:
Practice Address - Street 1:5105 ELDORADO PKWY STE 150
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-8676
Practice Address - Country:US
Practice Address - Phone:214-387-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX405501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice