Provider Demographics
NPI:1467637231
Name:EXCEL DENTAL CLINIC OF DALLAS, PC
Entity Type:Organization
Organization Name:EXCEL DENTAL CLINIC OF DALLAS, PC
Other - Org Name:HAPPY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHI
Authorized Official - Middle Name:HUE
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-231-6382
Mailing Address - Street 1:4709 RAVENDALE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3838
Mailing Address - Country:US
Mailing Address - Phone:972-231-6382
Mailing Address - Fax:972-271-4511
Practice Address - Street 1:5459 LA SIERRA DR STE 105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2349
Practice Address - Country:US
Practice Address - Phone:214-363-7219
Practice Address - Fax:214-363-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty