Provider Demographics
NPI:1437553401
Name:NORTH RICHARDSON DENTISTRY ASSOCIATES, PC
Entity Type:Organization
Organization Name:NORTH RICHARDSON DENTISTRY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AN
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-231-2576
Mailing Address - Street 1:4637 HEDGCOXE RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3962
Mailing Address - Country:US
Mailing Address - Phone:972-377-8866
Mailing Address - Fax:972-377-8870
Practice Address - Street 1:610 OLD CAMPBELL RD
Practice Address - Street 2:SUITE 116
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3379
Practice Address - Country:US
Practice Address - Phone:972-231-2576
Practice Address - Fax:972-235-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty