Provider Demographics
NPI:1033960851
Name:PARKHAVEN DENTAL GUNTER PLLC
Entity Type:Organization
Organization Name:PARKHAVEN DENTAL GUNTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-896-9386
Mailing Address - Street 1:4722 LONGVUE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7548
Mailing Address - Country:US
Mailing Address - Phone:972-896-9386
Mailing Address - Fax:
Practice Address - Street 1:605 N PRESTON RD STE 100
Practice Address - Street 2:
Practice Address - City:GUNTER
Practice Address - State:TX
Practice Address - Zip Code:75058-4702
Practice Address - Country:US
Practice Address - Phone:972-896-9386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental