Provider Demographics
NPI:1073056396
Name:DEO K PUN DMD PLLC
Entity Type:Organization
Organization Name:DEO K PUN DMD PLLC
Other - Org Name:DANA DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LATEEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-708-5488
Mailing Address - Street 1:1780 NORTHWEST HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5220
Mailing Address - Country:US
Mailing Address - Phone:972-681-3333
Mailing Address - Fax:
Practice Address - Street 1:1780 NORTHWEST HWY
Practice Address - Street 2:SUITE 150
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5220
Practice Address - Country:US
Practice Address - Phone:972-681-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X, 1223E0200X, 1223P0700X, 126800000X
TX273281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty