Provider Demographics
NPI:1437312618
Name:LITTLE ROAD DENTAL GROUP, PA
Entity type:Organization
Organization Name:LITTLE ROAD DENTAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:SEHAT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-483-1692
Mailing Address - Street 1:4004 LITTLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4480
Mailing Address - Country:US
Mailing Address - Phone:817-483-1692
Mailing Address - Fax:817-483-1792
Practice Address - Street 1:4004 LITTLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4480
Practice Address - Country:US
Practice Address - Phone:817-483-1692
Practice Address - Fax:817-483-1792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty