Provider Demographics
NPI:1568982429
Name:ABSOLUTE SMILE DUNCANVILLE PLLC
Entity Type:Organization
Organization Name:ABSOLUTE SMILE DUNCANVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-896-9386
Mailing Address - Street 1:5729 LEBANON RD STE 144268
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-7260
Mailing Address - Country:US
Mailing Address - Phone:972-896-9386
Mailing Address - Fax:
Practice Address - Street 1:1459 ACTON AVE
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-3338
Practice Address - Country:US
Practice Address - Phone:972-896-9386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD0000X
TX22329261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental