# IDEAL DENTAL ALPHARETTA PC

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

## Provider details

- **NPI number:** 1730802679
- **Authorized official:** RODNEY ALLES DDS (OWNER)
- **Authorized official phone:** (972) 331-8079

## Contact information

- **Practice address:** 1155 BLUEGRASS CT STE 5, ALPHARETTA, GA 30004-2489
- **Practice address phone:** (943) 200-0018
- **Practice address fax:** (943) 444-5001
- **Mailing address:** PO BOX 840925, DALLAS, TX 75284-0925

## Taxonomy

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

## Other

- **Enumeration date:** 09/26/2022
- **Last updated:** 10/02/2023