Provider Demographics
NPI:1437523602
Name:MICHAEL NGUYEN NORTH TEXAS DENTAL
Entity Type:Organization
Organization Name:MICHAEL NGUYEN NORTH TEXAS DENTAL
Other - Org Name:NORTH TEXAS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-893-2800
Mailing Address - Street 1:2515 MASTERS STREET
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090
Mailing Address - Country:US
Mailing Address - Phone:903-893-2800
Mailing Address - Fax:903-893-2877
Practice Address - Street 1:2515 MASTERS STREET
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090
Practice Address - Country:US
Practice Address - Phone:903-893-2800
Practice Address - Fax:903-893-2877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-25
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24954122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty