Provider Demographics
NPI:1609199124
Name:ABSOLUTE FAMILY DENTAL CARE, P.A.
Entity Type:Organization
Organization Name:ABSOLUTE FAMILY DENTAL CARE, P.A.
Other - Org Name:HELOTES COSMETIC & FAMILY DENTISTRY, P.A.
Other - Org Type:Doing Business As
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:210-372-9090
Mailing Address - Street 1:12800 BANDERA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4682
Mailing Address - Country:US
Mailing Address - Phone:210-372-9090
Mailing Address - Fax:
Practice Address - Street 1:12800 BANDERA RD STE 100
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-4682
Practice Address - Country:US
Practice Address - Phone:210-372-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABSOLUTE FAMILY DENTAL CARE, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty