Provider Demographics
NPI:1548662786
Name:OPTIMAL DENTAL
Entity type:Organization
Organization Name:OPTIMAL DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-475-8908
Mailing Address - Street 1:241 18TH ST S
Mailing Address - Street 2:403
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-3405
Mailing Address - Country:US
Mailing Address - Phone:408-515-5902
Mailing Address - Fax:650-412-9633
Practice Address - Street 1:600 N DAIRY ASHFORD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1100
Practice Address - Country:US
Practice Address - Phone:408-515-5902
Practice Address - Fax:650-412-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty