Provider Demographics
NPI:1043640642
Name:REN DENTAL PLLC
Entity Type:Organization
Organization Name:REN DENTAL PLLC
Other - Org Name:SMILEY DENTAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUYNH
Authorized Official - Middle Name:HOA
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-446-3833
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-0909
Mailing Address - Country:US
Mailing Address - Phone:713-364-7980
Mailing Address - Fax:713-364-7985
Practice Address - Street 1:5962 RENWICK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-2406
Practice Address - Country:US
Practice Address - Phone:713-364-7980
Practice Address - Fax:713-364-7985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty