Provider Demographics
NPI:1164608428
Name:MA, MINHHA N (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINHHA
Middle Name:N
Last Name:MA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 N IH 35
Mailing Address - Street 2:STE A131
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1328
Mailing Address - Country:US
Mailing Address - Phone:512-821-2394
Mailing Address - Fax:
Practice Address - Street 1:12400 N IH 35
Practice Address - Street 2:STE 131
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-1327
Practice Address - Country:US
Practice Address - Phone:512-821-2394
Practice Address - Fax:877-681-3027
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice