Provider Demographics
NPI:1306200050
Name:DQ DENTAL SERVICES
Entity Type:Organization
Organization Name:DQ DENTAL SERVICES
Other - Org Name:FAMILY DENTAL CENTER OF HUTTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QUYNH
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-642-4106
Mailing Address - Street 1:208 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-4524
Mailing Address - Country:US
Mailing Address - Phone:512-642-4106
Mailing Address - Fax:512-410-3015
Practice Address - Street 1:208 MAIN ST
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-4524
Practice Address - Country:US
Practice Address - Phone:512-642-4106
Practice Address - Fax:512-410-3015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23531261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental