Provider Demographics
NPI:1184044737
Name:DENTAL GARDEN, PLLC
Entity Type:Organization
Organization Name:DENTAL GARDEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:YUNG
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-853-9215
Mailing Address - Street 1:8710 GRAND MISSION BOULEVARD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407
Mailing Address - Country:US
Mailing Address - Phone:281-853-9215
Mailing Address - Fax:281-853-9213
Practice Address - Street 1:8710 GRAND MISSION BOULEVARD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407
Practice Address - Country:US
Practice Address - Phone:281-853-9215
Practice Address - Fax:281-853-9213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27558122300000X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty