Organization
ATLANTIC DENTAL GROUP LLC
Active
Other names
Spire Dental&Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHALED TARBOUSH DDS (CEO/OWNER)
(816) 830-6766
Entity
Organization
Contact information
Practice address
7519 CULEBRA RD # 101, SAN ANTONIO, TX 78251-1501
(816) 830-6766
Mailing address
3 WALDEN ELMS, SAN ANTONIO, TX 78257-1232
(816) 830-6766
(210) 384-9386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
03/11/2025
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