Provider Demographics
NPI:1467655530
Name:MAI, MONIQUE HIEN THU (DDS)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:HIEN THU
Last Name:MAI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 HIGHWAY 6 S STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-4327
Mailing Address - Country:US
Mailing Address - Phone:281-759-2007
Mailing Address - Fax:281-759-2008
Practice Address - Street 1:2150 HIGHWAY 6 S STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-4327
Practice Address - Country:US
Practice Address - Phone:281-759-2007
Practice Address - Fax:281-759-2008
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX221411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice