Provider Demographics
NPI:1003269663
Name:DKH DENTISTRY PLLC
Entity Type:Organization
Organization Name:DKH DENTISTRY PLLC
Other - Org Name:CERCA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THIEN
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-232-2325
Mailing Address - Street 1:3500 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3873
Mailing Address - Country:US
Mailing Address - Phone:724-769-3609
Mailing Address - Fax:
Practice Address - Street 1:3500 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3873
Practice Address - Country:US
Practice Address - Phone:724-769-3609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23502122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty