| Ideal Dental of Northlake | |
|
5000 State Highway 114 Ste 130 Northlake TX 76262-2076 | |
| (940) 208-0130 | |
| Not Available |
| Full Name | Ideal Dental of Northlake |
|---|---|
| Speciality | Dentist |
| Location | 5000 State Highway 114 Ste 130, Northlake, Texas |
| Authorized Official Name and Position | Rodney Alles (OWNER) |
| Authorized Official Contact | 9723318079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Dental of Northlake Po Box 840925 Dallas TX 75284-0925 | Ideal Dental of Northlake 5000 State Highway 114 Ste 130 Northlake TX 76262-2076 Ph: (940) 208-0130 |
| NPI Number | 1376044859 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 05/12/2023 |
| Certification Date | 05/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376044859 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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