Provider Demographics
NPI:1326488032
Name:STONEBRIAR DENTAL LLP
Entity Type:Organization
Organization Name:STONEBRIAR DENTAL LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-668-5608
Mailing Address - Street 1:9300 WADE BLVD
Mailing Address - Street 2:STE # 230
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-2174
Mailing Address - Country:US
Mailing Address - Phone:972-668-5608
Mailing Address - Fax:972-668-5611
Practice Address - Street 1:9300 WADE BLVD
Practice Address - Street 2:STE # 230
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-2174
Practice Address - Country:US
Practice Address - Phone:972-668-5608
Practice Address - Fax:972-668-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX190581223G0001X
TX194181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty