# JASON S. DAABOUL DDS PA

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

## Provider details

- **NPI number:** 1407555121
- **Authorized official:** DR. JASON SAAD-EDDINE DAABOUL DDS (PRESIDENT)
- **Authorized official phone:** (817) 690-8088

## Contact information

- **Practice address:** 2800 WILLIAM D. TATE AVENUE, SUITE 200, GRAPEVINE, TX 76051
- **Practice address phone:** (817) 488-7885
- **Practice address fax:** (817) 421-6176
- **Mailing address:** 2800 WILLIAM D. TATE AVENUE, SUITE 200, GRAPEVINE, TX 76051
- **Mailing address phone:** (817) 488-7885
- **Mailing address fax:** (817) 421-6176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/02/2023
- **Last updated:** 03/02/2023