Organization
ACE DENTAL08 PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARONAV CHAKRAVARTY (BUSINESS MANAGER)
(201) 902-3014
Entity
Organization
Contact information
Practice address
301 CONSTITUTION DR STE 300, COPPERAS COVE, TX 76522-2658
(201) 925-0210
Mailing address
301 CONSTITUTION DR STE 300, COPPERAS COVE, TX 76522-2658
(201) 925-0210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29291
TSBDE
TX
Enumeration date
10/08/2018
Last updated
10/08/2018
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