Organization
GRAND DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAED AJLOUNI DDS (PRESIDENT)
(214) 995-0806
Entity
Organization
Contact information
Practice address
5437 E GRAND AVE, DALLAS, TX 75223-1914
(214) 821-4726
Mailing address
850 DALMALLEY LN, COPPELL, TX 75019-7931
(214) 821-4726
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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