Provider Demographics
NPI:1710046123
Name:DENTAL SUITE PA
Entity Type:Organization
Organization Name:DENTAL SUITE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRI
Authorized Official - Middle Name:ANH
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-849-1313
Mailing Address - Street 1:13250 FM 529 RD
Mailing Address - Street 2:D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-2647
Mailing Address - Country:US
Mailing Address - Phone:713-849-1313
Mailing Address - Fax:
Practice Address - Street 1:13250 FM 529 RD
Practice Address - Street 2:D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-2647
Practice Address - Country:US
Practice Address - Phone:713-849-1313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20221122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty