# IDEAL DENTAL OF ROAD RUNNER PLLC

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

## Provider details

- **NPI number:** 1649634007
- **Authorized official:** SULMAN AHMED DMD (CEO)
- **Authorized official phone:** (972) 361-0600

## Contact information

- **Practice address:** 8338 N LOOP 1604 W, BUILDING 1 STE 104, SAN ANTONIO, TX 78249-3481
- **Practice address phone:** (210) 877-9100
- **Mailing address:** 8338 N LOOP 1604 W, BUILDING 1 STE 104, SAN ANTONIO, TX 78249-3481
- **Mailing address phone:** (210) 877-9100

## Taxonomy

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

## Other

- **Enumeration date:** 04/11/2016
- **Last updated:** 03/29/2017