Provider Demographics
NPI:1508377169
Name:STANKY TEETH, PLLC
Entity Type:Organization
Organization Name:STANKY TEETH, PLLC
Other - Org Name:FRESH DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-400-1111
Mailing Address - Street 1:17 QUIET VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-5805
Mailing Address - Country:US
Mailing Address - Phone:832-370-7680
Mailing Address - Fax:281-741-8809
Practice Address - Street 1:10761 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-1857
Practice Address - Country:US
Practice Address - Phone:281-400-1111
Practice Address - Fax:281-741-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty