Organization
AQUA DENTAL OF TEXAS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARISHPAL VIRK (MANAGING MEMBER)
(310) 923-3787
Entity
Organization
Contact information
Practice address
307 E CAMP WISDOM RD, SUITE 305, DUNCANVILLE, TX 75116-2705
(310) 923-3787
Mailing address
307 E CAMP WISDOM RD, SUITE 305, DUNCANVILLE, TX 75116-2705
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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