Provider Demographics
NPI:1538792056
Name:HEART DENTAL PLLC
Entity type:Organization
Organization Name:HEART DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANA
Authorized Official - Middle Name:
Authorized Official - Last Name:NASAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:317-847-1291
Mailing Address - Street 1:3610 W PIONEER PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4502
Mailing Address - Country:US
Mailing Address - Phone:469-706-7057
Mailing Address - Fax:
Practice Address - Street 1:345 W FM 544 STE 100B
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4408
Practice Address - Country:US
Practice Address - Phone:469-969-0169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty