# IDEAL DENTAL OF ROANOKE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306225529
- **Authorized official:** SHALIN PATEL DMD (OWNER)
- **Authorized official phone:** (972) 331-8067

## Contact information

- **Practice address:** 860 EAST HIGHWAY 114, SUITE 200, ROANOKE, TX 76262
- **Practice address phone:** (817) 491-3000
- **Mailing address:** 860 EAST HIGHWAY 114, SUITE 200, ROANOKE, TX 76262
- **Mailing address phone:** (817) 491-3000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2015
- **Last updated:** 10/08/2024