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Organization
OUR DENTIST PLLC
Active
Organization
OUR DENTIST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALAKA ABHIJIT NESARIKAR D.D.S. (MEMBER MANAGER)
(972) 241-1352
Entity
Organization
Contact information
Practice address
8025 AMBIANCE WAY, PLANO, TX 75024-6839
(469) 688-3171
Mailing address
2736 VALLEY VIEW LN, #300, FARMERS BRANCH, TX 75234-4925
(972) 241-1352
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21144
TX
Other
Enumeration date
01/13/2011
Last updated
01/13/2011
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