Provider Demographics
NPI:1487345294
Name:ALL SEASONS DENTISTRY PLLC
Entity type:Organization
Organization Name:ALL SEASONS DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:SUNEEL
Authorized Official - Last Name:ARAVA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-446-8604
Mailing Address - Street 1:4450 E PALM VALLEY BLVD # B102
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-9477
Mailing Address - Country:US
Mailing Address - Phone:737-243-1111
Mailing Address - Fax:737-243-1240
Practice Address - Street 1:4450 E PALM VALLEY BLVD # B102
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-9477
Practice Address - Country:US
Practice Address - Phone:737-243-1111
Practice Address - Fax:737-243-1240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental