Provider Demographics
NPI:1386866697
Name:DR. LY DENTISTRY, P.A.
Entity Type:Organization
Organization Name:DR. LY DENTISTRY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THUONG
Authorized Official - Middle Name:DOMINIC
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-820-7294
Mailing Address - Street 1:2741 E BELT LINE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-5445
Mailing Address - Country:US
Mailing Address - Phone:972-820-7294
Mailing Address - Fax:972-820-8217
Practice Address - Street 1:2741 E BELT LINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-5445
Practice Address - Country:US
Practice Address - Phone:972-820-7294
Practice Address - Fax:972-820-8217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD205831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty