| NPI | 1982362018 |
|---|---|
| Doing Business As | IDEAL DENTAL FAYETTEVILLE |
| Entity Type | Organization |
| Authorized Contact | RODNEY ALLES Owner 972-331-8079 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2023-05-24 |