Provider Demographics
NPI:1689719783
Name:MELODY LANE DENTAL GROUP PC
Entity Type:Organization
Organization Name:MELODY LANE DENTAL GROUP PC
Other - Org Name:ANH B. DAO DDS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANH
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-992-7000
Mailing Address - Street 1:3520 SUNSET MEADOWS DRIVE
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-8865
Mailing Address - Country:US
Mailing Address - Phone:281-992-7000
Mailing Address - Fax:281-992-7005
Practice Address - Street 1:3520 SUNSET MEADOW DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8865
Practice Address - Country:US
Practice Address - Phone:281-992-7000
Practice Address - Fax:281-992-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15972122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty