# IDEAL DENTAL OF WILDERNESS OAK PLLC

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

## Provider details

- **NPI number:** 1376056986
- **Authorized official:** SULMAN AHMED DMD (CEO)
- **Authorized official phone:** (972) 361-0600

## Contact information

- **Practice address:** 23522 WILDERNESS OAK STE 107, SAN ANTONIO, TX 78258-2409
- **Practice address phone:** (210) 591-0109
- **Mailing address:** PO BOX 840925, DALLAS, TX 75284-0925

## Taxonomy

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

## Other

- **Enumeration date:** 11/06/2017
- **Last updated:** 05/08/2023