Provider Demographics
NPI:1881053734
Name:ADVANCED ENDODONTICS OF DFW
Entity type:Organization
Organization Name:ADVANCED ENDODONTICS OF DFW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAYEED
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:817-562-4141
Mailing Address - Street 1:1674 KELLER PKWY
Mailing Address - Street 2:#100
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3751
Mailing Address - Country:US
Mailing Address - Phone:817-562-4141
Mailing Address - Fax:817-562-4190
Practice Address - Street 1:1674 KELLER PKWY
Practice Address - Street 2:#100
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3751
Practice Address - Country:US
Practice Address - Phone:817-562-4141
Practice Address - Fax:817-562-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-21
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22744261QD0000X
TX28322261QD0000X
TX24429261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental