| Ideal Dental of Roanoke PLLC | |
|
860 East Highway 114 Suite 200 Roanoke TX 76262 | |
| (817) 491-3000 | |
| Not Available |
| Full Name | Ideal Dental of Roanoke PLLC |
|---|---|
| Speciality | Dentist |
| Location | 860 East Highway 114, Roanoke, Texas |
| Authorized Official Name and Position | Shalin Patel (OWNER) |
| Authorized Official Contact | 9723318067 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Dental of Roanoke PLLC 860 East Highway 114 Suite 200 Roanoke TX 76262 Ph: (817) 491-3000 | Ideal Dental of Roanoke PLLC 860 East Highway 114 Suite 200 Roanoke TX 76262 Ph: (817) 491-3000 |
| NPI Number | 1306225529 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306225529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
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