Provider Demographics
NPI:1467637496
Name:ABSOLUTE FAMILY DENTAL CARE, PA
Entity Type:Organization
Organization Name:ABSOLUTE FAMILY DENTAL CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HIEN
Authorized Official - Middle Name:THANH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-645-0000
Mailing Address - Street 1:7608 W MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-1928
Mailing Address - Country:US
Mailing Address - Phone:210-645-0000
Mailing Address - Fax:210-673-3616
Practice Address - Street 1:7608 W MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1928
Practice Address - Country:US
Practice Address - Phone:210-645-0000
Practice Address - Fax:210-673-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB19370-01OtherTX CHIP