Provider Demographics
NPI:1558761742
Name:DALLAS DENTISTRY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:DALLAS DENTISTRY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
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:469-467-6162
Mailing Address - Street 1:4637 HEDGCOXE RD STE 112
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3963
Mailing Address - Country:US
Mailing Address - Phone:469-467-6162
Mailing Address - Fax:469-467-8585
Practice Address - Street 1:4709 W PARKER RD STE 550
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3367
Practice Address - Country:US
Practice Address - Phone:469-467-6162
Practice Address - Fax:469-467-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22204122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty